title: Longitudinal Impact of Smoking and Smoking Cessation on Inflammatory Markers of Cardiovascular Disease Risk.
abstract: To evaluate longitudinal changes in 6 inflammatory markers that predict cardiovascular disease events among smokers making a quit attempt and to characterize their cross-sectional associations between smoking and smoking heaviness.
  
  
  
  In a longitudinal cohort study of contemporary smokers (n=1652), we evaluated (1) independent associations of smoking heaviness markers (exhaled carbon monoxide, cigarettes/d, pack-years) with inflammatory markers (C-reactive protein, D-dimer, fibrinogen, urinary F2isoprostane:creatinine [F2:Cr] ratio, white blood cell [WBC] count, myeloperoxidase) and (2) the effects of smoking cessation and continued smoking on these inflammatory markers after 1 year, among the 888 smokers who made an aided quit attempt as part of a randomized comparative effectiveness trial or standard care. There were strong, independent associations between smoking heaviness markers and the F2:Cr ratio, WBC, and myeloperoxidase (all Padj<0.001), but not high-sensitivity C-reactive protein, D-dimer, or fibrinogen. Participants were mean (SD) 49.6 years old (11.6), 54% women, 34% non-white, and smoked 16.8 cigarettes/d (8.5) for 27.3 pack-years (18.6). After 1 year, the 344 successful abstainers gained more weight (4.0 [6.0] versus 0.4 [5.7] pounds; P<0.001) and had larger increases in insulin resistance scores (P=0.02) than continuing smokers. Despite these increases, abstainers had significant decreases in F2:Cr ratio (P<0.001) and WBC counts (P<0.001). Changes in other markers were not related to quitting.
  
  
  
  Smoking heaviness is associated with increased F2:Cr ratio, myeloperoxidase, and WBC counts. Cessation improves the F2:Cr ratio and WBC counts independent of weight change, suggesting reduced inflammation related to less oxidant stress.
authors.affiliation: From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison.
authors.forename: Cecile C
authors.initials: CC
authors.lastname: King
authors.affiliation: From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Piper
authors.affiliation: From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Gepner
authors.affiliation: From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fiore
authors.affiliation: From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Baker
authors.affiliation: From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison. jhs@medicine.wisc.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control* / Q000652:urine; D057186:Comparative Effectiveness Research; D003404:Creatinine / Q000652:urine; D028441:F2-Isoprostanes / Q000652:urine; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000517:prevention & control* / Q000652:urine; D018836:Inflammation Mediators / Q000097:blood* / Q000652:urine*; D007958:Leukocyte Count; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D009195:Peroxidase / Q000097:blood; D065840:Protective Factors; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects* / Q000097:blood / Q000652:urine; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D028441:F2-Isoprostanes; D018836:Inflammation Mediators; D003404:Creatinine; D009195:Peroxidase
keywords: carbon monoxide; cardiovascular diseases; inflammation; oxidative stress; smoking