Adverse effects of cigarette smoking on exhaled breath carbon monoxide, blood carboxyhemoglobin, and hematological parameters amongst Sri Lankan adult tobacco smokers: A descriptive study

Abstract

INTRODUCTION Tobacco smoking is the single most preventable cause of death worldwide and a major risk factor for several non-communicable diseases. Tobacco smoking has both acute and chronic effects on hematological parameters. The study aims to assess the effects of smoking intensity on exhaled breath carbon monoxide (eCO), carboxyhemoglobin (COHb%) and hematological parameters. METHODS Adult male daily smokers (n=360) and matched non-smoking males (n=180) from Colombo district, Sri Lanka, were selected. Sociodemographic data, smoking habits and anthropometric data were recorded. An automated Smokerlyser (Smokerlyser®, Bedfont) was used to estimate eCO and COHb% in exhaled breath and Brinkman index was used to quantify the level of smoking exposure. A venous blood sample was analyzed for a full blood count. Smokers were compared with the non-smoking group. RESULTS Smokers had significantly higher values of eCO, COHb%, Hemoglobin (Hb), Hematocrit (HCT), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), total White Blood Cell total count (WBC), Lymphocyte count, Monocyte count, and Granulocyte count. The number of cigarettes per day, duration of smoking, and Brinkman index were positively correlated with eCO and COHb%. MCV and MCH were positively correlated with the number of cigarettes smoked per day, smoking duration, and Brinkman index. CONCLUSIONS The severity of smoking can be quantified by the exhaled breath CO and blood COHb% levels as these parameters correlate with the severity of smoking. Hematological parameters of smokers were affected with continued long-term low-intensity smoking.