Evaluation of oxidative stress and whole blood viscosity for clinical laboratory testing of smoking toxicity


  • Ezekiel U. Nwose Department of Community Health, Charles Sturt University
  • Phillip T. Bwititi Department of Biomedical Sciences, Charles Sturt University
  • Ross S. Richards Department of Community Health, Charles Sturt University




Clinical biomarkers, Smoking toxicity, Oxidative stress, Whole blood viscosity


Background: There are no clearly established clinical biochemical markers for cigarette smoking despite the knowledge that cigarette smoking is a risk factor for various diseases, especially cardiovascular complications of respiratory pathologies. However, there are reports of significant increases in blood viscosity and oxidative stress among smokers. The main objective of the study was to ascertain the association of toxicity from cigarette smoking on whole blood viscosity in our data.

Methods: This study analysed the archived clinical data of 20 cigarette smokers and 20 apparently healthy individuals.

Results: The data show that on average, oxidative stress levels are relatively the same between groups, while whole blood viscosity is statistically significantly lower in non-smokers compared to smokers.

Conclusions: This report suggests that oxidative stress induced whole blood hyper-viscosity could be a valid biomarker for laboratory testing of smoking toxicity among cigarette smokers.


Angrave D, Charlwood A, Wooden M. Working time and cigarette smoking: evidence from Australia and the United Kingdom. Soc Sci Med. 2014;112:72-9.

Cena H, Tesone A, Niniano R, Cerveri I, Roggi C, Turconi G. Prevalence rate of Metabolic Syndrome in a group of light and heavy smokers. Diabetol Metab Syndr. 2013;5(1):28.

D’Agostino RB, Vasan RS, Pencina MJ, et al. General Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study. Circulation. 2008;117(6):743-53.

Johnson MD, Schilz J, Djordjevic MV, Rice JR, Shields PG. Evaluation of in vitro assays for assessing the toxicity of cigarette smoke and smokeless tobacco. Cancer Epidemiol Biomarkers Prev. 2009;18(12):3263-304.

Thielen A, Klus H, Muller L. Tobacco smoke: unraveling a controversial subject. Exp Toxicol Pathol. 2008;60(2-3):141-56.

Aune E, Roislien J, Mathisen M, Thelle DS, Otterstad JE. The "smoker's paradox" in patients with acute coronary syndrome: a systematic review. BMC Med. 2011;9:97.

Granados-Castro LF, Rodriguez-Rangel DS, Montano M, Ramos C, Pedraza-Chaverri J: Wood smoke exposure induces a decrease in respiration parameters and in the activity of respiratory complexes I and IV in lung mitochondria from guinea pigs. Environ Toxicol. 2015;30(4):461-71.

Kurmi OP, Dunster C, Ayres JG, Kelly FJ. Oxidative potential of smoke from burning wood and mixed biomass fuels. Free Radic Res. 2013;47(10):829-35.

Rosa MJ, Yan B, Chillrud SN, Acosta LM, Divjan A, Jacobson JS, et al. Domestic airborne black carbon levels and 8-isoprostane in exhaled breath condensate among children in New York City. Environ Res. 2014;135:105-10.

Martins-Green M, Adhami N, Frankos M, Valdez M, Goodwin B, Lyubovitsky J, et al. Cigarette smoke toxins deposited on surfaces: implications for human health. PLoS One. 2014;9(1):e86391.

Samal IR, Maneesh M, Chakrabarti A. Evidence for systemic oxidative stress in tobacco chewers. Scand J Clin Lab Invest. 2006;66(6):517-22.

Stein JH, Bushara M, Bushara K, McBride PE, Jorenby DE, Fiore MC. Smoking cessation, but not smoking reduction, reduces plasma homocysteine levels. Clin Cardiol. 2002;25(1):23-6.

Tonstad S, Urdal P. Does short-term smoking cessation reduce plasma total homocysteine concentrations? Scand J Clin Lab Invest. 2002;62(4):279-84.

Salbas K. Effect of acute smoking on red blood cell deformability in healthy young and elderly non-smokers, and effect of verapamil on age- and acute smoking-induced change in red blood cell deformability. Scand J Clin Lab Invest. 1994;54(6):411-6.

Salbas K, Gurlek A, Akyol T. In vitro effect of nicotine on red blood cell deformability in untreated and treated essential hypertension. Scand J Clin Lab Invest. 1994;54(8):659-63.

Furer V, Hersch M, Silvetzki N, Breuer GS, Zevin S. Nicotiana glauca (tree tobacco) intoxication-two cases in one family. J Med Toxicol. 2011;7(1):47-51.

Benowitz NL, Hukkanen J, Jacob PI. Nicotine Chemistry, Metabolism, Kinetics and Biomarkers. In: Nicotine Psychopharmacology. Edited by Henningfield J, London E, Pogun S, vol. 192: Springer Berlin Heidelberg; 2009: 29-60.

Moyer TP, Charlson JR, Enger RJ, Dale LC, Ebbert JO, Schroeder DR, et al. Simultaneous analysis of nicotine, nicotine metabolites, and tobacco alkaloids in serum or urine by tandem mass spectrometry, with clinically relevant metabolic profiles. Clin Chem. 2002;48(9):1460-71.

Yue B, Kushnir MM, Urry FM, Rockwood AL. Quantitation of nicotine, its metabolites, and other related alkaloids in urine, serum, and plasma using LC-MS-MS. Methods Mol Biol. 2010;603:389-98.

Richards RS, Nwose EU. Blood viscosity at different stages of diabetes pathogenesis. Br J Biomed Sci. 2010;67(2):67-70.

Nwose EU, Cann NG. Whole blood viscosity issues VI: Association with blood salicylate level and gastrointestinal bleeding. North Am J Med Sci. 2010;2(10):457-60.

Nwose EU, Butkowski EG. Algorithm for whole blood viscosity: Implication for antiplatelet bleeding risk assessment. Austr J Med Sc. 2013;34(2):50-5.

Ridker PM, Brown NJ, Vaughan DE, Harrison DG, Mehta JL. Established and emerging plasma biomarkers in the prediction of first atherothrombotic events. Circulation. 2004;109(25 Suppl 1):IV6-19.

Lowe GD, Lee AJ, Rumley A, Price JF, Fowkes FG. Blood viscosity and risk of cardiovascular events: the Edinburgh Artery Study. Br J Haematol. 1997;96(1):168-73.

Nwose E, Richards R, Kerr P, Tinley R, Jelinek H. Oxidative damage indices for the assessment of subclinical diabetic macrovascular complications. Br J Biomed Sc. 2008;65(3):136-41.

American Lung Association. Trends in tobacco use [http://www.lung.org/ finding-cures/our-research/ trend-reports/ Tobacco-Trend-Report.pdf]

Galea G, Davidson RJ. Haematological and haemorheological changes associated with cigarette smoking. J Clin Pathol. 1985;38(9):978-84.

Imbriani M, Melotti A, Ghittori S. Methemoglobin and carboxyhemoglobin levels in smokers and non-smokers. G Ital Med Lav. 1987;9(1):11-4.

Borland C, Harmes K, Cracknell N, Mack D, Higenbottam T. Methemoglobin levels in smokers and non-smokers. Arch Environ Health. 1985;40(6):330-3.

Lodovici M, Bigagli E. Oxidative stress and air pollution exposure. Journal of toxicology. 2011; 2011:487074.

Barregard L, Sallsten G, Andersson L, et al. Experimental exposure to wood smoke: effects on airway inflammation and oxidative stress. Occup Environ Med. 2008;65(5):319-24.

Nwose EU, Cann NG, Butkowski E. Whole blood viscosity assessment issues III: Association with international normalized ratio and thrombocytopenia. North Am J Med Sci. 2010;2(7):301-5.




How to Cite

Nwose, E. U., Bwititi, P. T., & Richards, R. S. (2017). Evaluation of oxidative stress and whole blood viscosity for clinical laboratory testing of smoking toxicity. International Journal of Research in Medical Sciences, 4(6), 2332–2336. https://doi.org/10.18203/2320-6012.ijrms20161810



Original Research Articles