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Cited by 1Cardiovascular and exercise physiologyHigh Altitude and HypoxiaExercise and Physiological Responses

Tobacco smoking: A stimulus for blood volume expansion

Open access
Sotiridis, Alexandros, Dardamanis-Aidonas, Charalambos, Makris, Anastasios, Loukas, Ioannis, Geladas, Nickos, Koskolou, Maria·2026·Respiratory Physiology & Neurobiology
DOI 10.1016/j.resp.2025.104505
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Abstract

Tobacco smoking involves the inhalation of carbon monoxide (CO), a gas that binds to hemoglobin molecules to form carboxyhemoglobin (COHb), and thus acutely reduces arterial oxygen content. Whether regular tobacco smoking elicits a compensatory increase in hemoglobin mass (HbM) and concomitant gains in intravascular volumes of even relatively trained individuals was examined in the present study. Thirty young males were split in independent groups based on smoking status (CS; chronic smokers and NS; non-smokers) and aerobic fitness level (MF; more fit and LF; less fit) (CS-MF, CS-LF, NS-MF and NS-LF; n=8 for all but the first group). CS had been smoking >10 cigarettes·day -1 at least for the last three years. Assessed using an incremental running exercise test to exhaustion, the age-adjusted VO 2peak was selected as the criterion for the inclusion in the MF and LF groups, respectively. The CO-rebreathing technique was applied to assess HbM and intravascular blood volumes. A two-way ANOVA was performed to detect differences in means of hematological and endurance performance parameters. VO 2peak was found higher in MF groups (p<0.001) but was similar between groups of similar fitness level (p=0.57). Accordingly, peak aerobic speed was lower in CS (p<0.001) and LF groups (p=0.004). HbM (p=0.013), total blood (p=0.001) and red cell (p<0.001) volumes were higher in CS groups. Despite the underlying expansion in HbM and total blood volume in smokers of varying fitness levels, endurance performance seems to be impaired. Future research could develop insight into the regulation of hematocrit in smokers. • When matched for VO 2peak , smokers demonstrate a higher hemoglobin mass. • Peak aerobic speed is lower in trained smokers compared to non-smoker counterparts. • A homeostatic regulation of hematocrit might be implied in moderate smokers.

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  • Cites a retracted work: 10.1016/j.hjc.2022.05.005

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    Cited work 10.1016/j.hjc.2022.05.005 · retraction date not known · this paper published 2026-01

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  1. ACSM’s Guidelines for Exercise Testing and Prescription, 2026, 12th Edition. Wolters Kluwer, PhiladelphIa.

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Authors
Sotiridis, A., Dardamanis-Aidonas, C., Makris, A., Loukas, I., Geladas, N., & Koskolou, M.
Affiliations
National and Kapodistrian University of Athens (GR)
Corresponding author
Sotiridis, Alexandros
ORCID
Venue
Respiratory Physiology & Neurobiology
Publisher
Elsevier BV
Published
2026-01
Volume
339
Pages
104505
ISSN
1569-9048 (ISSN-L)
DOI
10.1016/j.resp.2025.104505
OpenAlex
W4415223850
Semantic Scholar
96cfdea4d9118c22d3da94147768b4c9a9b20e51
Cited by
1
References
72
Citations by year
2026: 1
FWCI
1.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Respiratory Physiology & Neurobiology (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Empeirikeion Idryma
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords
smoking, hemoglobin mass, blood volume expansion, carboxyhemoglobin, carbon monoxide, cardiorespiratory fitness, peak oxygen uptake, endurance performance, erythrocyte volume
MeSH terms
Tobacco Smoking, Adult, Blood Volume, Carbon Monoxide, Carboxyhemoglobin, Exercise Test, Hemoglobins, Humans, Male, Oxygen Consumption, Physical Fitness, Young Adult

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