Plasma nicotine concentration and the white blood cell count in smokers.

Abstract

The peripheral blood total white cell count is 20-25% higher in smokers than in non-smokers (for review see ref 1). Smoking probably causes the increase in white cell count. Thus the count is higher in those who smoke and inhale more,2 while a change in cigarette consumption is associated with a corresponding change in white cell count, and giving up smoking with a reduction in the count.3 Despite this evidence, the way in which smoking raises the white cell count is unknown. This study was conducted to determine if the white cell count in smokers is related to the concentration of nicotine in plasma or of carbon monoxide in end expired air. MethodsTwenty two healthy young men of European extraction employed in the hospital were studied. None took any medication or had abnormal spirometric values. Twelve were regular cigarette smokers (median age 22 years) and 10 were lifelong non-smokers (median age 23.5 years). All gave written consent to be studied, and the ethics committee approved the study.The subjects were studied between 2.35 and 4.40 pm. Exercise beforehand was prohibited but smokers were allowed to smoke as usual, except during the half hour before the samples of blood and expired air were taken, when all the subjects remained seated quietly. Samples of end expired air were obtained after a 20 second breath hold following maximal inspiration, and end expired carbon monoxide concentration was measured at once with an Ecolyzer 2000 series analyser (Energetics Science). A peripheral venous blood sample was taken immediately after the breath sample. The white cell count was measured with an ELT-800 automated whole blood analyser (Ortho Diagnostic Systems Inc), and plasma nicotine concentration by gas chromatography (smokers only). Correlation was determined with Spearman's rank coefficient, and a p value of < 0.05 was regarded as significant. ResultsIn smokers the median (range) duration of smoking was 6 (3-19) years, and usual daily consumption 18 (3-25) cigarettes. The number of cigarettes consumed on the test day was 7 (0-8), and the time between smoking the last cigarette and providing the breath and blood samples was 1.0 (0.6-14)hours.Address for reprint requests: Dr RG Taylor, Department of Thoracic Medicine, Royal Free Hospital, London, NW3 2QG. Accepted 5 November 1985The median (range) plasma nicotine concentration was 1 1.2 (0.1-36.8) ng/ml in the smokers, and that of end expired carbon monoxide concentration 25 (6-42) ppm in the smokers and 4.0 (3.5-4.5) ppm in the non-smokers. Plasma nicotine and end expired carbon monoxide concentrations were significantly correlated in smokers (r, = 0.91, p < 0.001).The mean (SD) white cell count was 7.37 (1.39) x 109/1 in the smokers and 6.73 (1.17) x 109/1 in the non-smokers. The white cell count was significantly related to the plasma nicotine concentration in smokers (r. = 0.58, p < 0.05), but not to cigarette consumption on the test day or on usual days, or to end expired carbon monoxide concentration in smokers or non-smokers. DiscussionThis study discl...

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Cigarette Smoking and Lower Respiratory Tract Infection

“…Smokers usually exhibit an elevated peripheral white blood cell count, around 30% higher than that of nonsmokers (Friedman et al, 1973;Yeung & Buncio, 1984;Mili et al, 1991). It has been shown a significant relationship between the white blood cell count in smokers and the plasma concentration of nicotine (Taylor et al, 1986). It has been suggested that nicotine induced catecholamine release might be the mechanism for this effect (Friedman et al, 1973).…”