Abstract
To further define the relation between smoking and vitamin C status, the dietary and serum vitamin C levels of 11,592 respondents in the second National Health and Nutrition Examination Survey (NHANES II) were analyzed. Smokers of 20 cigarettes daily had the lowest vitamin C dietary intake (79 mg, 95% CI:73, 84) and serum levels (0.82 mg/dl, 95% CI: 0.77, 0.86; 46.6 mumol/L, 95% CI: 43.7, 48.8), while smokers of 1-19 cigarettes daily had decreased vitamin C intake (97 mg; 95% CI: 90, 104 mg) and serum levels (0.97 mg/dl, 95% CI: 0.92, 1.03; 55.1 mumol/L, 95% CI: 52.2, 58.5) compared to respondents who had never smoked (109 mg, 95% CI: 105, 113 and 1.15 mg/dl, 95% CI: 1.11, 1.18; 65.3 mumol/L, 95% CI: 63.0, 67.0, respectively). This inverse association between both intake and serum levels of vitamin C and smoking was independent of age, sex, body weight, race, and alcoholic beverage consumption. Following further adjustment for dietary vitamin C intake, the negative correlation between cigarette smoking and serum vitamin C levels persisted. The risk of severe hypovitaminosis C (serum levels less than or equal to 0.2 mg/dl; 11.4 mumol/L) was increased in smokers, particularly when not accompanied by vitamin supplementation (odds ratio 3.0, 95% CI: 2.5, 3.6). These data suggest that even though smoking adversely affects preferences for vitamin C rich foods, the inverse association between smoking and serum vitamin C levels occurs independently of dietary intake.
Full text
PDF![158](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c5/1349925/717d157d5dd9/amjph00228-0032.png)
![159](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c5/1349925/b061fcc41151/amjph00228-0033.png)
![160](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c5/1349925/ee0784200c67/amjph00228-0034.png)
![161](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c5/1349925/b5373f1d1070/amjph00228-0035.png)
![162](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c5/1349925/d053a7572a43/amjph00228-0036.png)
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Andrews J., Brook M. Leucocyte-vitamin-C content and clinical signs in the elderly. Lancet. 1966 Jun 18;1(7451):1350–1351. doi: 10.1016/s0140-6736(66)92139-8. [DOI] [PubMed] [Google Scholar]
- Baines M. Vitamin C and exposure to alcohol. Int J Vitam Nutr Res Suppl. 1982;23:287–293. [PubMed] [Google Scholar]
- Basu T. K. Possible toxicological aspects of megadoses of ascorbic acid. Chem Biol Interact. 1977 Feb;16(2):247–250. doi: 10.1016/0009-2797(77)90134-x. [DOI] [PubMed] [Google Scholar]
- Block G. A review of validations of dietary assessment methods. Am J Epidemiol. 1982 Apr;115(4):492–505. doi: 10.1093/oxfordjournals.aje.a113331. [DOI] [PubMed] [Google Scholar]
- Brook M., Grimshaw J. J. Vitamin C concentration of plasma and leukocytes as related to smoking habit, age, and sex of humans. Am J Clin Nutr. 1968 Nov;21(11):1254–1258. doi: 10.1093/ajcn/21.11.1254. [DOI] [PubMed] [Google Scholar]
- Chow C. K., Thacker R. R., Changchit C., Bridges R. B., Rehm S. R., Humble J., Turbek J. Lower levels of vitamin C and carotenes in plasma of cigarette smokers. J Am Coll Nutr. 1986;5(3):305–312. doi: 10.1080/07315724.1986.10720134. [DOI] [PubMed] [Google Scholar]
- Davies H. E., Davies J. E., Hughes R. E., Jones E. Studies on the absorption of L-xyloascorbic acid (vitamin C) in young and elderly subjects. Hum Nutr Clin Nutr. 1984 Nov;38(6):469–471. [PubMed] [Google Scholar]
- Fehily A. M., Phillips K. M., Yarnell J. W. Diet, smoking, social class, and body mass index in the Caerphilly Heart Disease Study. Am J Clin Nutr. 1984 Oct;40(4):827–833. doi: 10.1093/ajcn/40.4.827. [DOI] [PubMed] [Google Scholar]
- Fisher M., Gordon T. The relation of drinking and smoking habits to diet: the Lipid Research Clinics Prevalence Study. Am J Clin Nutr. 1985 Mar;41(3):623–630. doi: 10.1093/ajcn/41.3.623. [DOI] [PubMed] [Google Scholar]
- Forthofer R. N. Investigation of nonresponse bias in NHANES II. Am J Epidemiol. 1983 Apr;117(4):507–515. doi: 10.1093/oxfordjournals.aje.a113568. [DOI] [PubMed] [Google Scholar]
- GOLDBERG A. The anaemia of scurvy. Q J Med. 1963 Jan;32:51–64. [PubMed] [Google Scholar]
- Garry P. J., Goodwin J. S., Hunt W. C., Gilbert B. A. Nutritional status in a healthy elderly population: vitamin C. Am J Clin Nutr. 1982 Aug;36(2):332–339. doi: 10.1093/ajcn/36.2.332. [DOI] [PubMed] [Google Scholar]
- Grunberg N. E. The effects of nicotine and cigarette smoking on food consumption and taste preferences. Addict Behav. 1982;7(4):317–331. doi: 10.1016/0306-4603(82)90001-6. [DOI] [PubMed] [Google Scholar]
- Hines J. D. Letter: Ascorbic acid and vitamin B12 deficiency. JAMA. 1975 Oct 6;234(1):24–24. [PubMed] [Google Scholar]
- Hodges R. E., Hood J., Canham J. E., Sauberlich H. E., Baker E. M. Clinical manifestations of ascorbic acid deficiency in man. Am J Clin Nutr. 1971 Apr;24(4):432–443. doi: 10.1093/ajcn/24.4.432. [DOI] [PubMed] [Google Scholar]
- Hornig D. H., Glatthaar B. E. Vitamin C and smoking: increased requirement of smokers. Int J Vitam Nutr Res Suppl. 1985;27:139–155. [PubMed] [Google Scholar]
- Kallner A. B., Hartmann D., Hornig D. H. On the requirements of ascorbic acid in man: steady-state turnover and body pool in smokers. Am J Clin Nutr. 1981 Jul;34(7):1347–1355. doi: 10.1093/ajcn/34.7.1347. [DOI] [PubMed] [Google Scholar]
- Kevany J., Jessop W., Goldsmith A. The effect of smoking on ascorbic acid and serum cholesterol in adult males. Ir J Med Sci. 1975 Dec;144(12):474–477. [PubMed] [Google Scholar]
- Kinsman R. A., Hood J. Some behavioral effects of ascorbic acid deficiency. Am J Clin Nutr. 1971 Apr;24(4):455–464. doi: 10.1093/ajcn/24.4.455. [DOI] [PubMed] [Google Scholar]
- Krasner N., Dow J., Moore M. R., Goldberg A. Ascorbic-acid saturation and ethanol metabolism. Lancet. 1974 Sep 21;2(7882):693–695. doi: 10.1016/s0140-6736(74)93266-8. [DOI] [PubMed] [Google Scholar]
- Lamden M. P. Dangers of massive vitamin C intake. N Engl J Med. 1971 Feb 11;284(6):336–337. doi: 10.1056/nejm197102112840625. [DOI] [PubMed] [Google Scholar]
- Leggott P. J., Robertson P. B., Rothman D. L., Murray P. A., Jacob R. A. The effect of controlled ascorbic acid depletion and supplementation on periodontal health. J Periodontol. 1986 Aug;57(8):480–485. doi: 10.1902/jop.1986.57.8.480. [DOI] [PubMed] [Google Scholar]
- Loh H. S., Watters K., Wilson C. W. The effects of aspirin on the metabolic availability of ascorbic acid in human beings. J Clin Pharmacol. 1973 Nov-Dec;13(11):480–486. doi: 10.1002/j.1552-4604.1973.tb00203.x. [DOI] [PubMed] [Google Scholar]
- McCORMICK W. J. Ascorbic acid as a chemotherapeutic agent. Arch Pediatr. 1952 Apr;69(4):151–155. [PubMed] [Google Scholar]
- McClean H. E., Dodds P. M., Abernethy M. H., Stewart A. W., Beaven D. W. Vitamin C concentration in plasma and leucocytes of men related to age and smoking habit. N Z Med J. 1976 Apr 14;83(561):226–229. [PubMed] [Google Scholar]
- Newton H. M., Schorah C. J., Habibzadeh N., Morgan D. B., Hullin R. P. The cause and correction of low blood vitamin C concentrations in the elderly. Am J Clin Nutr. 1985 Oct;42(4):656–659. doi: 10.1093/ajcn/42.4.656. [DOI] [PubMed] [Google Scholar]
- Pelletier O. Smoking and vitamin C levels in humans. Am J Clin Nutr. 1968 Nov;21(11):1259–1267. doi: 10.1093/ajcn/21.11.1259. [DOI] [PubMed] [Google Scholar]
- Pelletier O. Vitamin C status of cigarette smokers and nonsmokers. Am J Clin Nutr. 1970 May;23(5):520–524. doi: 10.1093/ajcn/23.5.520. [DOI] [PubMed] [Google Scholar]
- Reuler J. B., Broudy V. C., Cooney T. G. Adult scurvy. JAMA. 1985 Feb 8;253(6):805–807. [PubMed] [Google Scholar]
- Schorah C. J., Newill A., Scott D. L., Morgan D. B. Clinical effects of vitamin C in elderly inpatients with low blood-vitamin-C levels. Lancet. 1979 Feb 24;1(8113):403–405. doi: 10.1016/s0140-6736(79)90882-1. [DOI] [PubMed] [Google Scholar]
- Smith J. L., Hodges R. E. Serum levels of vitamin C in relation to dietary and supplemental intake of vitamin C in smokers and nonsmokers. Ann N Y Acad Sci. 1987;498:144–152. doi: 10.1111/j.1749-6632.1987.tb23758.x. [DOI] [PubMed] [Google Scholar]
- Smithard D. J., Langman M. J. Vitamin C and drug metabolism. Br Med J. 1977 Apr 16;1(6067):1029–1030. doi: 10.1136/bmj.1.6067.1029-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Van Steirteghem A. C., Robertson E. A., Young D. S. Influence of large doses of ascorbic acid on laboratory test results. Clin Chem. 1978 Jan;24(1):54–57. [PubMed] [Google Scholar]