title: Changes in hemorheological and biochemical parameters following short-term and long-term smoking cessation induced by nicotine replacement therapy (NRT).
abstract: OBJECTIVE
  Cigarette smoking causes cardiovascular (CV) disease, but the relative roles of nicotine and other components of tobacco smoke remain unclear. We investigated the effect of stopping smoking by using nicotine replacement therapy (NRT) on hemorheology parameters, on the cotinine and thiocyanate plasma concentrations and the exhaled carbon monoxide (CO).
  
  
  METHODS
  Open, parallel-group trial (intervention group and control smokers).
  
  
  METHODS
  197 males, aged 25-45 years, smoking > 20 cigarettes per day (cpd).
  
  
  METHODS
  164 subjects were instructed to stop smoking and received NRT for 12 weeks and 33 acted as controls. After 12 weeks, NRT was discontinued and all subjects were followed-up at 26 weeks. Beginning with week 4, the treated subjects were divided into abstainers (self-reported, verified by exhaled CO < 10 ppm) and nonabstainers, not able to stay abstinent since baseline. The group of the nonabstainers was stratified in 2 subgroups, the reducers (smoked < 50% of baseline number of cpd) and relapsers (smoked 50-100% of baseline cpd).
  
  
  METHODS
  Plasma viscosity, erythrocyte deformability, fibrinogen, transcutaneous partial oxygen tension (tcpO2), hematocrit, white blood cells, cotinine and thiocyanate plasma concentrations and exhaled CO, all assessed at 4, 8, 12 and 26 weeks.
  
  
  RESULTS
  After 6 months, plasma fibrinogen (228.2 vs. 275.4 mg/dl at baseline, p < 0.001), tcpO2 (50.4 vs. 34.9 mm mercury at baseline, p < 0.0001) were significantly improved in abstainers, but changes in plasma viscosity and erythrocyte deformability were inconclusive. Cotinine and thiocyanate (abstainers: 6.2 ng/ml at week 26 vs. 10.4 ng/ml at baseline, p < 0.0001) and expired CO (abstainers: 30.4 vs. 4.2 ppm, control vs. week 26, p < 0.0001) accurately followed the changes in smoking and/or NRT use in all of the groups. Other CV risk factors such as hematocrit and white blood cell count decreased to a greater extent in abstainers than in reducers and relapsers. Not only abstainers but also reducers did benefit of the temporarily stop smoking.
  
  
  CONCLUSIONS
  Smoking cessation improved CV parameters despite the measured cotinine and thiocyanate plasma levels, and use of nicotine medications did not negate these improvements. A smoking cessation for a short time and smoking of reduced cpd also improved these parameters temporarily.
authors.affiliation: Fritz-Lickint-Institute for Nicotine Research and Smoking Cessation, Erfurt, Germany. haustein@inr-online.de
authors.forename: K O
authors.initials: KO
authors.lastname: Haustein
authors.forename: J
authors.initials: J
authors.lastname: Krause
authors.forename: H
authors.initials: H
authors.lastname: Haustein
authors.forename: T
authors.initials: T
authors.lastname: Rasmussen
authors.forename: N
authors.initials: N
authors.lastname: Cort
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D001809:Blood Viscosity / Q000187:drug effects; D002248:Carbon Monoxide / Q000378:metabolism; D003367:Cotinine / Q000097:blood; D004907:Erythrocyte Deformability / Q000187:drug effects; D005340:Fibrinogen / Q000187:drug effects; D005881:Gingiva; D006801:Humans; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000494:pharmacology*; D016540:Smoking Cessation; D013861:Thiocyanates / Q000097:blood
chemical_list: D013861:Thiocyanates; D009538:Nicotine; D002248:Carbon Monoxide; D005340:Fibrinogen; D003367:Cotinine; C031760:thiocyanate