The endocrine effects of nicotine and cigarette smoke

doi:10.1016/j.tem.2012.03.006

Trends in Endocrinology & Metabolism

Volume 23, Issue 7, July 2012, Pages 334-342

https://doi.org/10.1016/j.tem.2012.03.006 Get rights and content

With a current prevalence of approximately 20%, smoking continues to impact negatively upon health. Tobacco or nicotine use influences the endocrine system, with important clinical implications. In this review we critically evaluate the literature concerning the impact of nicotine as well as tobacco use on several parameters of the endocrine system and on glucose and lipid homeostasis. Emphasis is on the effect of smoking on diabetes mellitus and obesity and the consequences of smoking cessation on these disorders. Understanding the effects of nicotine and cigarettes on the endocrine system and how these changes contribute to the pathogenesis of various endocrine diseases will allow for targeted therapies and more effective approaches for smoking cessation.

Section snippets

Epidemiology of nicotine use

Cigarette smoking is a major public health issue in both the US and worldwide placing an enormous burden on the US economy. Approximately 20% (∼60 million) of Americans smoke [1]. In addition, in 2008 in the US, approximately 88 million nonsmokers aged ≥3 years were exposed to second-hand smoke [2]. Previous declines in rates of tobacco use have stalled over the past 5 years [3]. Cigarette smoking (first- and second-hand) and exposure to nicotine are associated with premature death from chronic

Brief overview of the endocrine system

The endocrine system is a group of glands that maintain body homeostasis via the secretion of different hormones. Many of these hormones are regulated via various regulatory axes including the hypothalamic–pituitary–adrenal axis (HPA), the hypothalamic–pituitary–gonadal axis (HPG), and the hypothalamic–pituitary–thyroid axis (HPT).

The HPA axis is activated with the release of corticotropin-releasing hormone (CRH) from the hypothalamus, typically in response to psychological or physical stress.

Cigarette smoking and osteoporosis

The association between smoking and osteoporosis is well established [44] with increased hip fractures seen in smokers [45]. Calcium absorption and vitamin D levels are lower in smokers [46], with variable reports on PTH levels 47, 48. In addition, cigarette smoking may reduce the efficacy of estradiol therapy in increasing bone mass [49]. The literature in humans clearly shows a relation between smoking and osteoporosis, and smoking cessation efforts should help decrease the rate of

Obesity

It has long been recognized that smokers generally have reduced body-weight compared to nonsmokers [50], that smoking cessation leads to weight gain [50], and that weight loss recurs when cigarette smoking is resumed [51]. Studies have reported a U-shaped relation between body mass index (BMI) and number of cigarettes smoked [52], with weight gain in the heavy smokers that correlates positively with number of cigarettes smoked [53], possibly influenced by poorer lifestyle habits among heavy

Concluding remarks

We have examined how nicotine exposure from smoking affects hormonal levels and metabolic homeostasis, using information from both humans and animal studies. The effect of smoking in thyroid disease, osteoporosis, and lipid levels has also been discussed. With the high prevalence of smoking throughout the world and the growing burden of diabetes, smoking cessation of patients should be actively pursued as part of prevention and management of diabetes regiments. However, the challenge of weight

Acknowledgments

This work was supported by a grant from the Minority Institutions’ Drug Abuse Research Development Program (MIDARP, grant R24DA017298).

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Trends in Endocrinology & Metabolism

ReviewThe endocrine effects of nicotine and cigarette smoke

Section snippets

Epidemiology of nicotine use

Brief overview of the endocrine system

Cigarette smoking and osteoporosis

Obesity

Concluding remarks

Acknowledgments

Pharmacol. Biochem. Behav.

Pharmacol. Biochem. Behav.

Psychoneuroendocrinology

Life Sci.

Int. J. Psychophysiol.

Biochem. Pharmacol.

Clin. Ther.

J. Sex Med.

Growth Horm. IGF Res.

J. Pharmacol. Toxicol. Methods

Metabolism

J. Clin. Densitom.

Bone

Prev. Med.

Prev. Med.

Peptides

Metabolism

Neurosci. Lett.

Mol. Cells

Am. J. Clin. Nutr.

Int. J. Hyg. Environ. Health

Diabetes Metab.

Atherosclerosis

Ann. Epidemiol.

J. Hepatol.

Am. Heart J.

Life Sci.

Mutat. Res.

Cigarette smoking – United States, 1965–2008

MMWR Surveill. Summ.

Cigarette smoking among adults – United States 2007

MMWR

Vital signs: current cigarette smoking among adults aged > or = 18 years – United States, 2009

Morb. Mortal. Wkly. Rep.

Association of serum TSH with high body mass differs between smokers and never-smokers

J. Clin. Endocrinol. Metab.

Thyroid hormone levels associated with active and passive cigarette smoking

Thyroid

Serum TSH levels in smokers and non-smokers. The 5th Tromso study

Exp. Clin. Endocrinol. Diabetes

Smoking is negatively associated with the presence of thyroglobulin autoantibody and to a lesser degree with thyroid peroxidase autoantibody in serum: a population study

Eur. J. Endocrinol.

Natural history of the transition from euthyroidism to overt autoimmune hypo- or hyperthyroidism: a prospective study

Eur. J. Endocrinol.

Discontinuation of smoking increases the risk for developing thyroid peroxidase antibodies and/or thyroglobulin antibodies: a prospective study

J. Clin. Endocrinol. Metab.

Graves’ ophthalmopathy

N. Engl. J. Med.

Smoking and thyroid-associated ophthalmopathy: a novel explanation of the biological link

J. Clin. Endocrinol. Metab.

Nicotine elevates rat plasma ACTH by a central mechanism

J. Pharmacol. Exp. Ther.

Motives for smoking and their correlates in clients attending Stop Smoking treatment services

Nicotine Tob. Res.

Stress, smoking, and 9/11/01

Psychiatry

Stress decreases the ability to resist smoking and potentiates smoking intensity and reward

J. Psychopharmacol.

How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General

Effects of acute psychosocial stress on cigarette craving and smoking

Nicotine Tob. Res.

The effect of stopping smoking on perceived stress levels

Addiction

Smoking and infertility

Fertil. Steril.

Alcohol intake and cigarette smoking: impact of two major lifestyle factors on male fertility

Indian J. Pathol. Microbiol.

Review
The endocrine effects of nicotine and cigarette smoke