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Updated: Apr 14, 2026

Cigarette Smoke Exposure in Mice using a Whole-Body Inhalation System
Published on: October 22, 2020
Influences of smoking behaviors on human immune signatures: large observational studies and Mendelian randomization
Meng Zhou1, Chunxiang Jia2, Yifei Zhang3
1Department of Hematology, Tongde Hospital of Zhejiang Province Affiliated to Zhejiang Chinese Medical University, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang 310012, China.
Introduction:
Although exposure to cigarette smoking is known to impair immune function, the specific immune components involved remain unclear.
Methods:
We conducted multiple regression analyses to assess associations between smoking behaviors and immune markers-including white blood cell counts, pathogen-specific antibodies, and SARS-CoV-2 antibody seropositivity post-vaccination, by using data from the UK Biobank (n = 499 244) and the National Health and Nutrition Examination Survey (n = 66 947). We further used two-sample Mendelian randomization analysis to reveal the causal relationships between smoking and different immune cell phenotypes, and plasma antibodies against various pathogens.
Results:
Observational studies revealed that ever-smokers had elevated white blood cell and neutrophil counts compared to never-smokers, with current smokers also showing a higher increase in white blood cell and neutrophil counts, along with a decrease in lymphocyte percentage and monocyte percentage. Current smokers had greater seropositivity for Epstein-Barr Virus, herpes simplex virus-2, and Chlamydia trachomatis (Definition I). Additionally, current smokers had reduced SARS-CoV-2 antibody seropositivity following both first and second vaccine doses. Mendelian randomization analyses demonstrated that smoking initiation, age of initiation, cigarettes per day, cessation, and lifetime smoking causally influenced 73, 25, 44, 36, and 17 immune cell phenotypes, respectively. Notably, smoking initiation and lifetime smoking reduced anti-SARS-CoV-2 spike IgG seropositivity after the second vaccination.
Conclusions:
Our findings demonstrate that smoking significantly alters leukocyte composition, impairs immune cell populations, and influences pathogen-specific antibody responses-most notably diminishing the humoral response to SARS-CoV-2 vaccination. These results suggest that smoking may compromise both innate and adaptive immunity.
Implications:
While prior studies have demonstrated that cigarette smoking significantly impacts the immune system, the comprehensive effects on immune signatures and the specific cell types or factors involved remain unclear. To address this gap, our study integrates large-scale observational data from the UK Biobank and the National Health and Nutrition Examination Survey to examine associations between smoking behaviors and major white blood cell types, antibodies against pathogens, and SARS-CoV-2 antibody seropositivity post-vaccination. Furthermore, we employed two-sample Mendelian randomization analyses to investigate causal relationships between smoking behaviors and immune cell phenotypes alongside plasma antibodies.
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