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Submitted on October 2, 2006
Accepted on December 12, 2006
Ellena Badrick BSc, MSc,e.badrick@ucl.ac.uk., Department of Epidemiology and Public Health, University College London, London, WC1E 6BT; Meena Kumari PhD, International Institute for Society and Health, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT; Clemens Kirschbaum PhD, Biological Psychology, Technical University of Dresden, D-01062 Dresden, Germany
* To whom correspondence should be addressed. E-mail: e.badrick{at}ucl.ac.uk.
Context: Evidence for an association of smoking status with cortisol secretion is mixed.
Objective: To assess the relationship between smoking status and salivary cortisol.
Design: Cross sectional study of smoking status and cortisol secretion from phase 7 (2002-2004) of the Whitehall II study.
Setting: Occupational cohort originally recruited in 1985-1987.
Participants: 3103 men (1514 never smokers, 1278 ex-smokers, and 311 smokers) and 1128 women (674 never smokers, 347 ex-smokers and 107 smokers). Information was collected on smoking status, average number of cigarettes smoked, and additional covariates.
Outcome measures: Saliva samples were taken on waking, waking + 0.5, 2.5, 8, 12 hours and bedtime for the assessment of cortisol.
Results: Smoking status was significantly associated with increased salivary cortisol release throughout the day (p<0.001) adjusted for covariates, this was apparent for the cortisol awakening response (CAR) (p<0.001) when examined separately. Compared to never smokers, smokers had higher release of total cortisol, p=0.002, while no difference was observed between never smokers and ex-smokers (p=0.594), [mean release per hour nmol/l: never smokers 4.13 (CI: 4.02-4.24), ex-smokers 4.21 (CI: 4.08-4.35), smokers 4.63 (CI: 4.35-4.93)]. There was no significant relationship between number of cigarettes smoked and total cortisol release. However, a difference was observed for the CAR: mean release by tertiles of cigarettes smoked (nmol/l): high 13.49(CI:10.74-16.23), medium 9.58(CI:7.40-11.76), low 8.49(CI:5.99-10.99) p=0.029.
Conclusion: Salivary cortisol is increased in current smokers compared with non- smokers, no differences were observed between ex-smokers and never smokers suggesting that smoking has a short-term affect on the neuroendocrine system.
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