High sensitivity C-reactive protein and D-dimer levels in a sample of Iraqi cigarettes, shisha and electronic cigarettes smokers

According to the world health organization (WHO), the tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than 8 million people a year around the world. Since the emergence of various smoking methods, many claims and controversies have risen regarding the safety of each type of these smoking methods or which of them causes more adverse health effects. As such, we aimed in this study to investigate the effect of three types of smoking, namely, cigarette smoking, shisha smoking, and vape smoking, on the serum levels of high-sensitivity CRP (Hs-CRP) and D-dimer. This study involved the collection of blood samples from 100 cigarette smokers, 100 shisha smokers, 100 electronic cigarette (also known as vape) smokers and 200 apparently healthy subjects serving as the control group. Blood levels of Hs-CRP and D-dimer were measured in all of the study subjects. The results showed significantly increased levels of Hs-CRP and D-dimer in cigarette smokers compared to shisha and vape smokers and also to the control group. Levels of Hs-CRP and D-dimer were also significantly higher in shisha smokers compared to the vape smokers and the control group. It is concluded that cigarette smokers are at higher risk for future cardiovascular and thrombotic events, followed by shisha smokers and, at last, vape smokers. Levels of Hs-CRP and D-dimer in vape smokers were within the normal range, suggesting that electronic cigarette smoking is much safer compared to cigarettes and shisha smoking. However, due to the higher levels of Hs-CRP and D-dimer in vape smokers compared to the control group, it is suggested that even vaping might have an impact or adverse health effect compared to non-smokers.