Early Indicators Of Alterations In Hematological And Inflammatory Biomarkers Among Smoking And Smokeless Tobacco Users - Comparative Analysis

Abstract

Background: In India, 1 million tobacco-related deaths occur every year. Consumption of smoking and smokeless tobacco products was a more common practice. This study aimed to assess and compare hematological and inflammatory markers among smoking and smokeless tobacco users.

Material and methods: Ninety participants were recruited and divided into three groups: 30 smokers, 30 smokeless tobacco users, and age- and BMI-matched 30 healthy controls. The levels of hsCRP and complete blood count (CBC) were measured.

Results: Significant differences were observed in mean corpuscular volume (MCV) and neutrophil levels in both tobacco user groups compared to controls. Eosinophils were reduced in smokers but elevated in smokeless tobacco users, while basophils and monocytes were decreased in both groups. hsCRP levels were markedly elevated in both smokers and smokeless tobacco users, indicating systemic inflammation. The neutrophil-to-lymphocyte ratio (NLR) was significantly increased among smokers, suggesting a stronger systemic impact of smoking compared to smokeless tobacco use.

Conclusion: These findings emphasize the need for early monitoring of hematological and inflammatory biomarkers among tobacco users. Significant changes in MCV, neutrophils, eosinophils, basophils, monocytes, and elevated hsCRP levels and NLR suggest systemic inflammation and altered immune responses in tobacco users. While some hematological parameters remained unchanged, elevated inflammatory markers such as hsCRP and NLR in smokers indicate a stronger systemic impact of tobacco use. This study helps to guide targeted public health interventions and preventive strategies.