A Pilot Study To Examine the Effects of Smoking Cessation on Serum Markers of Inflammation in Women at Risk for Cardiovascular Disease

Abstract

Background The links between smoking, inflammation, and cardiovascular disease (CVD) are well-established. Several studies demonstrate that quitting smoking reverses the risk of coronary heart disease within five to ten years. However, the immediate effects of quitting smoking on inflammatory biomarkers associated with CVD risk are not well described. Methods In this pilot study, we examined a panel of circulating inflammatory biomarkers associated with CVD in ‘at risk’ women during the smoking cessation process. Forty-six women enrolled in a smoking cessation program consented to attend 4 study visits over 6–7 weeks. Health/medical information and blood was collected at each visit. Circulating levels of C-reactive protein (CRP), TNF, IL-6, soluble TNF receptors I and II, and soluble VCAM-1 were measured and changes between baseline levels (visit 1, while smoking) and visits 2–4 were determined. Results Significant reductions in circulating TNF, soluble TNF receptors I and II, and soluble VCAM-1 were observed among participants over the smoking cessation process. Both serum IL-6 and CRP levels declined during the smoking cessation process; however the changes were not statistically significant. Conclusions These findings suggest that there are rapid consequences of smoking cessation on inflammatory biomarkers in women at risk for CVD. Additional, larger studies including diverse smokers desiring to quit are required to confirm changes in ‘measurable milestones’ which could serve as motivating factors to assist smokers to quit.

Associations of Cigarette Smoking With Subclinical Inflammation and Atherosclerosis: ELSA‐Brasil (The Brazilian Longitudinal Study of Adult Health)

“…In addition, hsCRP is associated with atherosclerotic processes40 and thus may also be directly involved in cardiovascular injury. The high sensitivity of this test, as indicated by significant differences via secondhand smoking exposure and consistent results for different indices of tobacco exposure in ELSA‐Brasil and across other studies,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 41 highlights hsCRP as a favorable marker for monitoring hazardous health effects of tobacco exposure.…”

“…These studies have generally shown higher levels of hsCRP among current and former smokers compared with nonsmokers5, 6, 9, 10, 12, 13, 14, 15 and decreased levels after smoking cessation, albeit slower than systolic blood pressure and total cholesterol and LDL‐C 8, 11, 12. Calculating the probability of CAC onset following smoking exposure in the Heinz Nixdorf Recall study also demonstrated that onset of CAC was expedited by 10 years among current smokers and 5 years among former smokers compared with never smokers 16.…”

Smoking Cessation Program with Exercise Improves Cardiovascular Disease Biomarkers in Sedentary Women

“…Given that there is an increasing number of reports where smoking cessation may temporarily elevate the risk for type 2 diabetes, 51 even smaller changes can be clinically significant and serve as a motivator for the participants. 64 …”

The Role of Smoking Cessation in the Prevention of Coronary Artery Disease

“…The removal of tobacco smoke results in the elimination of the deleterious effects of the thousands of chemicals contained in cigarette smoke. Within weeks of cessation endothelial function, coagulation parameters, carboxyhemoglobin levels, lipoproteins, proinflammatory agents, and inflammatory biomarkers decline and circulatory function improves dramatically [29,30]. For the patient with CAD, the result is a highly significant reduction in the likelihood of progression or complication of existing disease, and there is a significant reduction in the possibility of hospital readmission, morbidity, and all-cause mortality [31••].…”