Effects of Opium Addiction and Cigarette Smoking on Hematological Parameters

Document Type : Original Article(s)


1 Neuroscience Research Center, Institute of Neuropharmacology AND Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

2 Associate Professor, Department of Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Assistant Professor, Department of Laboratory Sciences, School of Paramedicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

4 PhD Student, Department of Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Professor, Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences AND Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran


Background: The aim of the present study was to investigate the effects of opium addiction and cigarette smoking on the complete blood count (CBC).Methods: Eighty-six male subjects, including 31 opium-addicted cigarette smokers (OACS), 19 opium-addicted non-cigarette smokers (OANCS), 17 non-opium-addicted cigarette smokers (NOACS), and 19 non-opium-addicted non-cigarette smokers (NOANCS) participated in this study. The CBC test was measured in all individuals.Findings: The OACS had significantly higher white blood cell (WBC), lymphocyte, and red blood cell (RBC) count but lower in mean corpuscular volume (MCV) compared to NOANCS. The OANCS had significantly higher lymphocyte in comparison with NOACS. Our results demonstrated that the number of WBC, lymphocytes, and RBC were significantly higher, while, MCV was lower in OANCS subjects when compared to NOACS. The OACS had significantly higher level of lymphocyte in comparison with NOACS. The mean number of lymphocyte in OANCS was found significantly higher than NOACS. The smokers were shown to have significantly higher levels of WBC compared to NOANCS.Conclusion: Our results showed that opium-addiction, especially when associated with cigarette smoking, has intensive effects on hematological factors and these alteration might leads to greater risk for developing atherosclerosis, cardiovascular diseases, and imbalance in immune system.


  1. Condoluci A, Mazzara C, Zoccoli A, Pezzuto A, Tonini G. Impact of smoking on lung cancer treatment effectiveness: a review. Future Oncol 2016; 12(18): 2149-61.
  2. Van Tiel E, Peeters PH, Smit HA, Nagelkerke NJ, Van Loon AJ, Grobbee DE, et al. Quitting smoking may restore hematological characteristics within five years. Ann Epidemiol 2002; 12(6): 378-88.
  3. Tarazi IS, Sirdah MM, El Jeadi H, Al Haddad RM. Does cigarette smoking affect the diagnostic reliability of hemoglobin alpha 2 delta 2 (HbA2)? J Clin Lab Anal 2008; 22(2): 119-22.
  4. Fernandez JA, Prats JM, Artero JV, Mora AC, Farinas AV, Espinal A, et al. Systemic inflammation in 222.841 healthy employed smokers and nonsmokers: white blood cell count and relationship to spirometry. Tob Induc Dis 2012; 10(1): 7.
  5. Asadikaram G, Sirati-Sabet M, Asiabanha M, Shahrokhi N, Jafarzadeh A, Khaksari M. Hematological changes in opium addicted diabetic rats. Int J High Risk Behav Addict 2013; 1(4): 141-8.
  6. Schiff PL Jr. Opium and its alkaloids. Am J Pharm Educ 2002; 66(2): 186-94.
  7. Liang X, Liu R, Chen C, Ji F, Li T. Opioid system modulates the immune function: a review. Transl Perioper Pain Med 2016; 1(1): 5-13.
  8. Franchi S, Castelli M, Moretti S, Panerai A, Sacerdote P. Evaluation of murine macrophage cytokine production after in vivo morphine treatment. Methods Mol Biol 2015; 1230: 253-61.
  9. Suzuki S, Chuang LF, Doi RH, Chuang RY. Morphine suppresses lymphocyte apoptosis by blocking p53-mediated death signaling. Biochem Biophys Res Commun 2003; 308(4): 802-8.
  10. Brown JN, Ortiz GM, Angel TE, Jacobs JM, Gritsenko M, Chan EY, et al. Morphine produces immunosuppressive effects in nonhuman primates at the proteomic and cellular levels. Mol Cell Proteomics 2012; 11(9): 605-18.
  11. Ke Y, Ye K, Grossniklaus HE, Archer DR, Joshi HC, Kapp JA. Noscapine inhibits tumor growth with little toxicity to normal tissues or inhibition of immune responses. Cancer Immunol Immunother 2000; 49(4-5): 217-25.
  12. Hiser L, Herrington B, Lobert S. Effect of noscapine and vincristine combination on demyelination and cell proliferation in vitro. Leuk Lymphoma 2008; 49(8): 1603-9.
  13. Schuler M, Muehlbauer P, Guzzie P, Eastmond DA. Noscapine hydrochloride-induced numerical aberrations in cultured human lymphocytes: a comparison of FISH detection methods and multiple end-points. Mutagenesis 2003; 18(3): 235-42.
  14. Sajadian S, Vatankhah M, Majdzadeh M, Kouhsari SM, Ghahremani MH, Ostad SN. Cell cycle arrest and apoptogenic properties of opium alkaloids noscapine and papaverine on breast cancer stem cells. Toxicol Mech Methods 2015; 25(5): 388-95.
  15. Svetlecic J, Molteni A, Herndon B. Bronchiolitis obliterans induced by intratracheal papaverine: a novel animal model. Lung 2004; 182(2): 119-34.
  16. Troy DB, Remington JP, Beringer P. Remington: the science and practice of pharmacy. Philadelphia, PA: Lippincott Williams and Wilkin; 2006.
  17. Karam GA, Rashidinejad HR, Aghaee MM, Ahmadi J, Rahmani MR, Mahmoodi M, et al. Opium can differently alter blood glucose, sodium and potassium in male and female rats. Pak J Pharm Sci 2008; 21(2): 180-4.
  18. Asadikaram G, Asiabanha M, Sayadi A, Jafarzadeh A, Hassanshahi G. Impact of opium on the serum levels of TGF-beta in diabetic, addicted and addicted-diabetic rats. Iran J Immunol 2010; 7(3): 186-92.
  19. Nabati S, Asadikaram G, Arababadi MK, Shahabinejad G, Rezaeian M, Mahmoodi M, et al. The plasma levels of the cytokines in opium-addicts and the effects of opium on the cytokines secretion by their lymphocytes. Immunol Lett 2013; 152(1): 42-6.
  20. Eisenstein TK, Hilburger ME. Opioid modulation of immune responses: effects on phagocyte and lymphoid cell populations. J Neuroimmunol 1998; 83(1-2): 36-44.
  21. Carvalho TT, Borghi SM, Pinho-Ribeiro FA, Mizokami SS, Cunha TM, Ferreira SH, et al. Granulocyte-colony stimulating factor (G-CSF)-induced mechanical hyperalgesia in mice: Role for peripheral TNFalpha, IL-1beta and IL-10. Eur J Pharmacol 2015; 749: 62-72.
  22. McCarty MF. Interleukin-6 as a central mediator of cardiovascular risk associated with chronic inflammation, smoking, diabetes, and visceral obesity: down-regulation with essential fatty acids, ethanol and pentoxifylline. Med Hypotheses 1999; 52(5): 465-77.
  23. Asakura H, Kawamoto K, Igimi S, Yamamoto S, Makino S. Enhancement of mice susceptibility to infection with Listeria monocytogenes by the treatment of morphine. Microbiol Immunol 2006; 50(7): 543-7.
  24. Sioud M, Floisand Y. NOD2/CARD15 on bone marrow CD34+ hematopoietic cells mediates induction of cytokines and cell differentiation. J Leukoc Biol 2009; 85(6): 939-46.
  25. Vallejo R, de Leon-Casasola O, Benyamin R. Opioid therapy and immunosuppression: a review. Am J Ther 2004; 11(5): 354-65.
  26. Stampfli MR, Anderson GP. How cigarette smoke skews immune responses to promote infection, lung disease and cancer. Nat Rev Immunol 2009; 9(5): 377-84.
  27. Lavi S, Prasad A, Yang EH, Mathew V, Simari RD, Rihal CS, et al. Smoking is associated with epicardial coronary endothelial dysfunction and elevated white blood cell count in patients with chest pain and early coronary artery disease. Circulation 2007; 115(20): 2621-7.
  28. Vulser H, Wiernik E, Tartour E, Thomas F, Pannier B, Czernichow S, et al. Smoking and the Association Between Depressive Symptoms and Absolute Neutrophil Count in the Investigations Preventives et Cliniques Cohort Study. Psychosom Med 2015; 77(9): 1039-49.
  29. Smith MR, Kinmonth AL, Luben RN, Bingham S, Day NE, Wareham NJ, et al. Smoking status and differential white cell count in men and women in the EPIC-Norfolk population. Atherosclerosis 2003; 169(2): 331-7.
  30. Zhang B, Gao C, Hou Q, Yin J, Xie L, Pu S, et al. Different independent susceptibility markers for first-ever cerebral infarction and myocardial infarction in young patients. J Neurol 2012; 259(7): 1420-5.
  31. Seinen ML, van Asseldonk DP, de Boer NK, Losekoot N, Smid K, Mulder CJ, et al. The effect of allopurinol and low-dose thiopurine combination therapy on the activity of three pivotal thiopurine metabolizing enzymes: results from a prospective pharmacological study. J Crohns Colitis 2013; 7(10): 812-9.
  32. Madjid M, Awan I, Willerson JT, Casscells SW. Leukocyte count and coronary heart disease: implications for risk assessment. J Am Coll Cardiol 2004; 44(10): 1945-56.
  33. Hashemi Domeneh B, Tavakoli N, Jafari N. Blood lead level in opium dependents and its association with anemia: A cross-sectional study from the capital of Iran. J Res Med Sci 2014; 19(10): 939-43.
  34. Rezende SM, Lijfering WM, Rosendaal FR, Cannegieter SC. Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk. Haematologica 2014; 99(1): 194-200.
  35. Raval M, Paul A. Cerebral venous thrombosis and venous infarction: case report of a rare initial presentation of smoker's polycythemia. Case Rep Neurol 2010; 2(3): 150-6.
  36. White JL, Farrier EG. Method for preparing carbon fuel for smoking articles and product produced thereby (Publication Number: CA 1284025 C). [Patent]. 1991.
  37. Gomperts ED, Forman HJ. Solution of carbon monoxide for treatment of disease, including sickle cell disease (Publication Number: EP 2663193 A1). [Patent]. 2013.
  38. Chan YY, Yang SN, Lin JC, Chang JL, Lin JG, Lo WY. Inflammatory response in heroin addicts undergoing methadone maintenance treatment. Psychiatry Res 2015; 226(1): 230-4.