Abstract

Background: This study aimed to investigate the effects of daily smoking on lipid profile, atherogenic plasma index (API), and systemic immune-inflammation index (SII) in individuals with chronic diseases such as diabetes, hypertension, hyperlipidemia, and hypothyroidism.

Methods: This descriptive study included 49 participants from a total of 150 individuals who applied to the Kayseri Melikgazi Healthy Life Center Nutrition and Diet Clinic between September 2024 and September 2025. Participants had at least one chronic disease (diabetes, hypertension, hyperlipidemia, hypothyroidism), complete biochemical data, and provided written informed consent. Occasional smokers, former smokers, individuals with chronic obstructive pulmonary disease (COPD), asthma, malignancy, or those using immunosuppressive drugs were excluded. Participants were divided into two groups: daily smokers (n = 34) and non-smokers (n = 15). Fasting lipid profile and complete blood count were measured, and API and SII values were calculated. Between-group comparisons were performed using the t-test or Mann–Whitney U test.

Results: In the smoking group (n=34; 23 males, mean age 56.9 ± 11.3 years; 11 females, mean age 51.2 ± 10.5 years), compared with the non-smoking group (n=15; 6 males, mean age 57.0 ± 11.2 years; 9 females, mean age 49.8 ± 10.1 years), HDL-cholesterol was significantly lower (41.9 ± 12.0 mg/dL vs. 52.9 ± 14.1 mg/dL; p = 0.013) and SII was significantly higher (644 ± 383 vs. 422 ± 181; p = 0.028). In participants with diabetes mellitus (n = 32), SII was significantly higher in smokers compared with non-smokers (725.9 ± 472.4 vs. 419.8 ± 187.5; p = 0.035). Additionally, API values were higher in smokers than non-smokers and across all chronic disease subgroups, although the differences were not statistically significant.

Conclusion: In individuals with chronic diseases, daily smoking is associated with lower HDL-cholesterol levels and higher SII values. The findings highlight the impact of smoking on systemic inflammation and underscore the importance of evaluating smoking status in the management of chronic diseases. In addition, incorporating composite indices such as SII and API into clinical practice may allow for a more sensitive assessment of cardiometabolic risk.

Keywords: smoking, chronic disease, dyslipidemias, high-density lipoprotein cholesterol, triglycerides, inflammation

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Copyright © 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

Ergüder, B. İ., Alemdar, M., Nouri Nojadeh, J., Yılmaz Türker, A., & Yazıhan, N. (2026). Effects of smoking on atherogenic plasma index, lipid profile, and systemic immune-inflammation index in individuals with chronic diseases. Turkish Journal of Tobacco Control, 6(1), 15-24. https://doi.org/10.64511/TJTC.2026.40