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Cited by 101Smoking Behavior and CessationHormonal and reproductive studiesSperm and Testicular Function

Cigarette smoking and testosterone in men and women: A systematic review and meta-analysis of observational studies

Zhao, Jie, Leung, June Yue Yan, Lin, Shi Lin, Mary Schooling, C.·2016·Preventive Medicine
DOI 10.1016/j.ypmed.2015.12.021
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Abstract

Recently Health Canada and the Food and Drug Administration warned about the cardiovascular risk of testosterone, making environmental drivers of testosterone potential prevention targets. Cotinine, a tobacco metabolite, inhibits testosterone breakdown. We assessed the association of smoking with testosterone in a systematic review and meta-analysis, searching PubMed and Web of Science through March 2015 using ("testosterone" or "androgen" or "sex hormone") and ("smoking" or "cigarette"). Two reviewers independently searched, selected, assessed quality and abstracted with differences resolved by consensus or reference to a third reviewer. The initial search yielded 2881 studies; 28 met the selection criteria. In 22 studies of 13,317 men, mean age 18-61years, smokers had higher mean testosterone than non-smokers (1.53nmol/L, 95% confidence interval (CI) 1.11 to 1.96) using a random effects model with inverse variance weighting. In 6 studies of 6089 women, mean age 28-62years, smoking was not clearly associated with testosterone (0.11nmol/L, 95% CI -0.08 to 0.30). Fixed effects models provided similar results, but suggested a positive association in women. Whether products which raise cotinine, such as e-cigarettes or nicotine replacement, also raise testosterone, should be investigated, to inform any regulatory action for e-cigarettes, which emit nicotine into the surrounding air, with relevance for both active and passive smokers.

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Authors
Zhao, J., Leung, J. Y. Y., Lin, S. L., & Mary Schooling, C.
Affiliations
University of Hong Kong (HK)
ORCID
Venue
Preventive Medicine
Publisher
Elsevier BV
Published
2016-04
Volume
85
Pages
1-10
ISSN
0091-7435 (ISSN-L)
DOI
10.1016/j.ypmed.2015.12.021
OpenAlex
W2226440260
Semantic Scholar
54f8378e0127d249e7c9031d1b9bfb36a2e3ce2c
Cited by
101
References
87
Citations by year
2026: 9 · 2025: 11 · 2024: 17 · 2023: 10 · 2022: 5 · 2021: 7 · 2020: 12 · 2019: 12 · 2018: 10 · 2017: 5 · 2016: 3
FWCI
1.13
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
Keywords
cigarette smoking, testosterone, sex hormones, cotinine, cardiovascular risk, electronic cigarettes, nicotine replacement therapy, passive smoking, sex differences, androgens
MeSH terms
Adolescent, Adult, Cotinine, Female, Humans, Male, Middle Aged, Smoking, Testosterone, Young Adult, Observational Studies as Topic

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