Abstract
Background: Smoking-induced hypoxia, inflammation, and oxidative stress result in impairment of hematological parameters. Contradictory evidence is found as far as the effect of smoking on blood cells and indices is concerned.

Aims and Objectives: Very few studies have evaluated male smokers for the presence or absence of anemia. Thus, the present study was undertaken to study the hematological parameters in male smokers and find the presence of anemia and find a correlation between the severity of smoking and hemoglobin (Hb), red blood cell (RBC), and white blood cell (WBC).

Materials and Methods: The present study included 100 male smokers divided into anemic (n = 34) and non-anemic (n = 66) groups. RBC, WBC, Hb, and blood indices (mean corpuscular volume [MCV] and mean corpuscular Hb concentration [MCHC]) were compared and further evaluation was done on the basis of severity of smoking (as per the pack-years). Correlation between pack-years and RBC, Hb, and WBC was done. Data were analyzed using statistical tests such as unpaired t-test, Chi-square, ANOVA, and Pearson’s correlation. P < 0.05 was taken as statistically significant.

Results: There were significant differences (P < 0.05) in the mean age, MCV, MCHC, and WBC between the two groups and with increase in severity of smoking, the levels of Hb, RBC, MCV and MCHC, and WBC were increased significantly in smokers with anemia when compared to those without anemia. In smokers with anemia, the highest percentage was found in mild smoker category (19/34, i.e., 55.88%) and with increase in smoking severity, the number of anemic subjects decreased. In smokers without anemia, the highest percentage was found in mild smoker category (37/66, i.e., 56.06%). The difference in anemic and non-anemic smokers on the basis of severity of smoking was found to be insignificant (P > 0.05). The correlation of pack-years with Hb, RBC, and WBC was found to be significantly (P < 0.05) positive.

Conclusion: RBC, Hb, MCV, and MCHC were significantly higher in anemic smokers as compared to non-anemic smokers and with increase in the smoking severity the percentage of anemic subjects declined. It may be concluded that there appears a link between smoking and alterations in hematological parameters.

Key words: Smoking; Male Gender; Pack-Years; Anemia; Severity; Correlation