Cardiovascular Disease risk Factors in Male Cigarette Smokers in Calabar, Southern Nigeria

Document Type : Original Article


1 Department of Medical Laboratory Science, University of Calabar, PMB 1115 Calabar, Cross River State, Nigeria

2 Department of Chemical Pathology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria


Cigarette smoking has been linked to atherosclerosis, coronary artery disease, peripheral vascular disorders and various malignancies. However, the mechanism by which smoking increases the risk of cardiovascular diseases is still controversial. One hundred and forty one apparently healthy male cigarette smokers and sixty apparently healthy non-smokers aged 18 to 65 years were enrolled into the study. The smokers were sub-divided into light (<8 pack years), moderate (8-30 pack years) and heavy (>30 pack years) smokers. Anthropometric indices and blood pressure were measured. Fasting plasma glucose, total cholesterol (TC), triglycerides and High density lipoprotein-cholesterol (HDL-C) were estimated using colorimetric test methods while low density lipoprotein-cholesterol (LDL-C) and very low density lipoprotein were calculated using Friedewald’s equation. Serum insulin was estimated using ELISA. Data was analyzed using SPSS version 20.0; level of significance was set at p<0.05. The smokers had significantly higher diastolic BP (p=0.0001), TC (p= 0.008) and LDL-C (p = 0.0001) and significantly lower HDL-C (p = 0.0001) compared to the non-smokers. There was a significant higher fasting plasma glucose in the light smokers (p=0.001) than in the moderate and heavy smokers whereas, serum TC and LDL-C levels were significantly increased in heavy smokers (p=0.001) than in the light and moderate smokers. There was a negative correlation between BMI and smoking pack years. Dyslipidaemia was observed to be the most prevalent cardiovascular disease risk factor. It is concluded that the alterations in lipid profile and blood pressure observed in this study may contribute to higher risk of cardiovascular disease.


1. World Health Organization, Tobacco; World health Organization, 2014; Fact sheet No 339.
2. World Health Organization. WHO report on the Global Tobacco Epidemic 2017- Retrieved from Updated July 19, 2017. Assessed February 16, 2018.
3. World Health Organization. Tobacco. WHO Fact sheet, 2018; Retrieved from updated March 9, 2018. Retrieved May 21, 2018.
4. Global Adult Tobacco Survey (GATS): Country report, 2012; Nigeria.
5. Bassey I.E., Akpan U.O., Elijah O.E., Bankong S.O., 2018.  Thyroid function determinants, calcium, phosphate and vitamin D in adult male smokers in Calabar, Nigeria. Journal of Medical & Allied Sciences. 8(1), 7-12.
6. Mendis S., Puska P., Norving B., 2011. Global atlas on cardiovascular disease prevention and control. World Health Organisation in collaboration with world heart federation and world stroke organization: Geneva.
7. Vasudevan D.M., Sreekumari S., Kannan V., Textbook of Biochemistry, 6th ed., Jaypee Brothers Medical Publishers Limited: New Delhi, 2011
8. Devaranavadgi B.B., Aski B.S., Kashinath R.T., Hunderkari I.A., 2012.  Effect of cigarette smoking on Blood lipids-A study in Belgium, Northern Karnataka, India. Global Journal of Medical Research. 12(6), 206-221.
9. Hallit S., Zoghbi M., Hallit R., Youssef L., Costantine R., Kheir N., 2012. Effects of exclusive cigarette smoking and in combination with waterpipe smoking in lipoproteins. Journal of Epidemiology and Global Health. 7(4), 269-275.
10. Bajaj M., 2012. Nicotine and Insulin resistance; when the smoke clears. Diabetes. 61(12), 3078-3080.
11. Seet R.C., Loke W.M., Khoo C.M., Chew S.E., Chong W.L., Quek A.M., 2012. Acute effects of cigarette smoking on insulin resistance and arterial stiffness in young adults. Atherosclerosis. 224, 195-200.
12. Thuy A.B., Blizzard L., Schmidt M., Michael D., Luc P.H., Granger R.H., 2010. The association between smoking and hypertension in a population-based sample of Vietnamese men. Journal of Hypertension. 28(2), 245-250.
13. Leone A., 2011. Does smoking act as a friend or enemy of blood pressure? Let release Pandora’s box. Cardiology Research and Practice. 264894.
14. Daniel W.W. Biostatistics: A Foundation for analysis in the Health Sciences. 7th ed., New York: John Wiley & Sons, 1999.
15. World Health Organization. WHO Report on the Global Tobacco Epidemic. Country profile Nigeria. 2013. Assessed 19 February 2015. Available:
16. Mostafa T., 2010. Cigarette smoking and male infertility. Journal of Advanced Research. 1, 179-186.
17. World Health Organization. Obesity, prevention and management. Report of WHO expert committee. 2000. WHO Technical Report Series 894. Geneva, Switzerland.
18. Onyesom I., Osioma E., Testimi O.L., Rotu A.R., 2012. Biomarkers of metabolic syndrome in serum of some cigarette smokers in Delta State, Nigeria. American Journal of Biochemistry. 2(1), 7-10.
19. Zbikowski S.M., Jack L.M., McClure J.B., Deprey M., Javitz H.S., McAfee T., 2011. Utilization of services in a randomized trial testing phone and web based interventions for smoking cessation. Nicotine & Tobacco Research. 13(5), 319-27.
20. Plurphanswat N., Rodu B., 2014. The association of smoking and demographic characteristics on body mass index and obesity among adults in the U.S; 1999-2012. BMC Obesity. 1: 18. doi: 10.1186/s40608-014-0018-0
21. John U., Hanke M., Rumpf H.J., Thyrian J.R., 2005. Smoking status, cigarettes per day, and their relationship to overweight and obesity among former and current smokers in a national adult general population sample. International Journal of Obesity. 29, 1289-1294.
22. Chiolero A., Jacot-Sadowski I., Faeh D., Paccaud F., Cornuz J., 2007. Association of cigarettes daily smoked with obesity in a general European adult population. Obesity Research. 15(5), 1311–8.
23. Suganthy K., Asothai R., Mohanty P.K., Shivasubrahmaniam R., Rajagopal V., Vijayabanu N.A., 2014. Study of obesity and insulin resistance among cigarette smokers for assessing the risk of type 2 DM. World Journal of Pharmacy and Pharmaceutical Sciences. 3(7), 1581-1590.
24. Houston T.K, Person S.D.M., Pletcher M.J., Liu K., Iribarren C., Kiefe C.I., 2006. Active and passive smoking and development of glucose in tolerance among young adults in a prospective cohort; CARDIA Study. British Medical Journal. 332(7549), 1064-1069.
25. Berlin I., Lin S., Lima J.A.C., Bertoni A.G., 2012. Smoking status and metabolic syndrome in the multi-ethnic study of atherosclerosis. A cross-sectional study. Tobacco Induced Diseases. 10(1).  doi: 10.1186/1617-9625-10-9
26. Reaven G.M., 1988. Banting lecture. Role of insulin resistance in human disease. Diabetes. 37, 1595–1607.
27. Borissova A.M., Tankova T., Kirilov G., Dakovska L., Krivoshiev S., 2004. The effect of smoking on peripheral
insulin sensitivity and plasma endothelial level. Diabetes and Metabolism. 30, 147-152.
28. Attval S., Fowelin J., Lager I., Von Schenck H., Smith U., 1993. Smoking induces insulin resistance: a potential link with the insulin resistance syndrome. Journal of Internal Medicine. 233, 327-332.
29. Omvik P., 1996. How smoking affects blood pressure. Blood Pressure. 5(2), 71-77.
30. Rhee M.Y., Na S.H., Kim Y.K., Lee M.M., 2007. Acute effects of cigarette smoking on arterial stiffness and blood pressure in male smokers with hypertension. American Journal of Hypertension. 20(6), 637-641.
30. Campbell S.C., Moffatt R.J., Stamford B.A., 2008. Smoking and smoking cessation- The relationship between cardiovascular disease and lipoprotein metabolism: A review. Atherosclerosis. 201, 225-35.
31. Prabha V., Waheeda S., MeritonStanly A., 2015. Effect of Tobacco Smoking on Lipid Profile. IndianJournal of Applied Research. 5, 562-564.
32. Omar T.D., Mohammed A.A.R., Hadeer A.A.R., Mohamed A.H., 2016. The impact of cigarette smoking on lipid profile among Iraqi smokers. International Journal of Collaborative Research on Internal Medicine & Public Health. 8(8), 491-500.
33. Bai-mei H., Shui-ping Z., Zhen-yu P., 2013. Effects of cigarette smoking on HDL quantity and function; Implications for atherosclerosis. Journal of Cellular Biochemistry. 114, 2431-2436.
34. Wakabayashi I., 2008. Associations of alcohol drinking and cigarette smoking with serum lipid levels in healthy middle-aged men. Alcohol and Alcoholism. 43(3), 274-80.
35. Belue R., Okoror T.A., Iwelunmor J., Taylor K.D., Degboe A.N., Agyemang C., 2009. An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective. Global Health. 5, 10. doi: 10.1186/1744-8603-5-10.