Nicotine addiction severity-based evaluation of ferritin, vitamin B12, and folic acid levels among female smokers: A two-year retrospective study

Melike Mercan Başpinar, Dersu Taş

Keywords: Addiction, smoking, vitamin, ferritin, nicotine dependence

Background:

Anemia due to iron deficiency is more common in women than in men and smoking-induced hypoxia result in impairment of hematological parameters, ferritin,and transferrin saturation. Additionally, smoking is known to cause macrocytosis mainly by altering the levels of Vitamin B12 and folic acid.

Research questions:

The overall aim of this project is to improve our knowledge of the difference in haematological alterations based on nicotine addiction severity among women. Does smoking severity lead to differences in ferritin, vitamin B12, folic acid levels, Hb, Hct, MCV, and transferrin saturation?

Method:

A retrospective study collecting data from the smoking cessation clinic of Gaziosmanpaşa Training and Research Hospital in Istanbul, Turkey, including two years follow-up between 2022 and 2024. The severity of smoking will be categorized based on the Heaviness of Smoking Index (HSI) as scoring 0-2: low addiction, 3-4: moderate addiction, and 5-6: high addiction. Males, subjects with chronic diseases, and those taking medications for anemia, or use of B12, folic acid, multivitamin supplements will be excluded from the study. F test for comparison of ferritin, vitamin B12, folic acid levels between low, moderate, high addiction groups will be used. The Ethics Committee will be approved. A p-value of less than 0.05 will be considered statistically significant.

Results:

Our study may show us haematological alterations unexpected for heavy smoking versus others among female smokers.

Conclusions:

Since smoking may cause and also mask deficiencies of some vitamins or minerals, smokers will be advised to first commit to lifestyle changes such as quitting smoking rather than taking any drug or supplements.

Points for discussion:

What should heavy smoking information make us think about when evaluating anemia or vitamin deficiency in women?

Reference 1-Stouten, K., Riedl, J. A., Droogendijk, J., Castel, R., van Rosmalen, J., van Houten, R. J., ... & Levin, M. D. (2016). Prevalence of potential underlying aetiology of macrocytic anaemia in Dutch general practice. BMC Family Practice, 17(1), 1-8. Reference 2-Çiftçiler, R., Guven, A., Haznedaroğlu, I., & Aksu, S. (2019). Effects Of Smoking On Hematological Parameters And Ferritin Levels. Haseki Tip Bulteni-Medical Bulletin Of Haseki, 57(4). Reference 3-Hadi, J. M., Shawkat, S. B., Rauf, H. G., Karim, S. A. H., Mustafa, A. M., Muhammad, S. N., & Abdullah, M. S. (2023). Effects of Smoking on Serum Ferritin levels in adult population living in Sulaymaniyah, Iraq: A Retrospective Cross-sectional Study. Iraq Medical Journal, 7(3).

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