Study of cardiovascular disease biomarkers among tobacco consumers. Part 3: evaluation and comparison with the US National Health and Nutrition Examination Survey

Abstract

Cardiovascular disease (CVD) biomarkers of biological effect (BoBE), including hematologic biomarkers, serum lipid-related biomarkers, other serum BoBE, and one physiological biomarker, were evaluated in adult cigarette smokers (SMK), smokeless tobacco consumers (STC), and non-consumers of tobacco (NTC). Data from adult males and females in the US National Health and Nutrition Examination Survey and a single site, cross-sectional study of healthy US males were analyzed and compared. Within normal clinical reference ranges, statistically significant differences were observed consistently for fibrinogen, C-reactive protein (CRP), hematocrit, mean cell volume, mean cell hemoglobin, hemoglobin, white blood cells, monocytes, lymphocytes, and neutrophils in comparisons between SMK and NTC; for CRP, white blood cells, monocytes, and lymphocytes in comparisons between SMK and STC; and for folate in comparisons with STC and NTC. Results provide evidence for differences in CVD BoBE associated with the use of different tobacco products, and provide evidence of a risk continuum among tobacco products and support for the concept of tobacco harm reduction.

• BoBE
• cigarettes
• CVD
• NHANES
• smokeless tobacco

Acknowledgements

The authors gratefully acknowledge Dr. Summer N. Hanna, Mr. David L. Heavner, Dr. Leanne R. Campbell, Dr. Ziad S. Naufal, Dr. Gaddamanugu L. Prasad, Mr. Thomas J. Steichen, and Dr. Eugenia H. Theophilus.

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Declaration of interest

All authors are current or former employees of R.J. Reynolds Tobacco Company and/or RAI Services Company.