Comparison of effects of cigarette and hookah smoking on human erythrogram: A Case control study
Abstract
Smoking is a serious public health problem that leads to death thousands of people every year, being a variant responsible for many changes in laboratory tests. Thus, the aim of this study was to compare erythrogram of cigarette smokers and hookah smokers. Forty-five subjects participated in this study: cigarette smokers (15), hookah smokers (15) and non-smokers (15). Between October and December 2017, after the volunteers answered a questionnaire about smoking habits, peripheral blood samples were collected and analyzed for red blood cells (RBC) count, hemoglobin (Hb) content and determination of hematocrit (HCT) and hematimetric indices by using manual methods. Analyses were completed in 2018. Regarding the frequency of use, cigarettes are consumed in great amount every day, unlike the hookah, which is usually used only on weekends. However, when compared to control group, both cigarette and hookah smokers showed a significant increase in HCT, Hb and RBC values, but nonsignificant differences in hematimetric indices (p < 0.05).Cigarette and hookah smokers showed a similar and increased erythrogram profile. Although hookah has not been shown to be more harmful than cigarettes, variables such as the frequency and duration of hookah sessions can be directly related to the severity and intensity of changes, demonstrating evidence that it could be more dangerous to health than cigarettes. Therefore, more detailed studies on hookah should be conducted.
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Introduction
Drugs are chemical substances that can modify all body functions, being divided into licit or illicit. Tobacco is a licit drug considered by the WHO to be a serious public health problem and the leading cause of avoidable death worldwide, since addiction and its degrees of intensity have complex mechanisms, making it difficult to quit smoking and generating high costs for the Unified Health System (SUS) with tobacco-related diseases. Tobacco smoke contains more than 4,720 toxic substances, such as nicotine, the active ingredient responsible for addiction; and carbon monoxide (CO), a toxic and carcinogenic gas that has a higher affinity for hemoglobin than oxygen. These substances can be found in any form of tobacco use, such as in cigarettes and hookah, harming both active and passive smokers exposed to these toxic substances.1-4
Nicotine acts in the brain through cholinergic receptors and its continuous use causes biological and physiological changes in the central nervous system. Thus, the brain of dependent people works differently from non-dependent.5 Meanwhile, when tobacco smoke is inhaled, CO binds with hemoglobin to produce carboxyhemoglobin (COHb), preventing the body tissues to receive a continuous and appropriate oxygen delivery and increasing erythropoiesis, which leads to changes in some hematological parameters that modify the results of laboratory tests, in addition to increasing the risk of cardiovascular and respiratory diseases, several kinds of cancer and other tobacco-related diseases when there is prolonged exposure to smoke.6, 7
Conclusion
This present study concluded that there was increased values of HCT, Hb and RBC in both cigarette and hookah smokers. Surprisingly hookah was found more harmful habit than cigarettes. It is necessary to consider some variables, such as the frequency and duration of hookah sessions, which show evidence that it could be more harmful to health, since it is inferred that the intensity of the changes is proportional to their consumption. More detailed studies are required to understand the characteristics of hookah.