Sigara Kullanımının Endokrin Sistem Üzerine Etkilerinin Değerlendirilmesi

Öz

Tüm dünyada yaygın olarak kullanılan sigara, dünya çapında önlenebilir hastalık ve ölümlerin önde gelen nedenlerinden biridir. Sigaranın küresel olarak kullanımının en önemli sebebi; içerisindeki nikotin ve diğer toksik bileşiklerin bağımlılık potansiyelinin yüksek olmasındandır. Sigara dumanına aktif ve pasif maruziyet sonucu pek çok kimyasal bileşik ve küçük partikül akciğerlerden inhale edilerek hızla kan dolaşımına girer. Bu maddeler ise kardiyovasküler sistem başta olmak üzere vücutta hemen hemen tüm organ ve sistemleri etkileyebilir. Sigara kullanımının endokrin sistem üzerine etkileri de son yıllarda önemli bir araştırma konusu haline gelmiş olup, azalmış fertilite, gebelikle ilgili istenmeyen sonuçlar ve yavrularda uzun vadeli olumsuz etkiler gibi reprodüktif sistem ile ilişkili pek çok araştırma yapılmıştır. Bununla birlikte erişkin fizyolojisi ve sağlıklı gelişim için esansiyel olan tiroid hormonları ile adrenal hormonlar üzerine etkileri de çalışmalarda tartışma konusudur. Son olarak yine endokrin bozucu etkilerinden kaynaklı diyabet riskindeki artış ile ilişkisi de çalışmalarda ön plana çıkmaktadır. Bu çalışma kapsamında, sigara kullanımının endokrin sistem üzerine etkilerinin değerlendirildiği çalışmalar derlenmiştir. Söz konusu çalışmaların sonuçları doğrultusunda, giderek yaygınlaşan sigara kullanımının önüne geçilerek sigaranın tetiklediği diyabet, kadın ve erkek üreme sistemi bozuklukları, tiroid ile ilgili problemler gibi kronik hastalıkların önlenebileceği vurgulanmıştır.

Anahtar Kelimeler

• Sigara
• Endokrin bozucu kimyasal maddeler
• Tiroid
• Diyabet
• Üreme sistemi

Evaluation of the Effects of Smoking on the Endocrine System

Abstract

Tüm dünyada yaygın olarak kullanılan sigara dünya çapında önlenebilir hastalık ve ölümlerin önde gelen nedenidir. Sigaranın küresel olarak kullanımının en önemli sebebi; içerisindeki nikotin ve diğer toksik bileşiklerin bağımlılık potansiyelinin yüksek olmasındandır. Sigara kullanımı ile dumanına aktif ve pasif maruziyet sonucu pek çok kimyasal bileşik ve küçük partikül akciğerlerden inhale edilerek hızla kan dolaşımına girer. Bu maddeler ise kardiyovasküler sistem başta olmak üzere vücutta hemen hemen tüm organ ve sistemleri etkileyebilir. Endokrin sistem üzerine etkileri de son yıllarda önemli bir araştırma konusu olup azalmış fertilite, olumsuz gebelik sonuçları ve yavrularda uzun vadeli olumsuz etkileri gibi reprodüktif sistem ile ilişkili pek çok araştırma yapılmıştır. Bununla birlikte erişkin fizyolojisi ve sağlıklı gelişim için esansiyel olan tiroid hormonları ile adrenal hormonlar üzerine etkileri de çalışmalarda tartışma konusudur. Son olarak yine endokrin bozucu etkilerinden kaynaklı diyabet riskindeki artış ile ilişkisi de çalışmalarda ön plana çıkmaktadır. Bu derleme kapsamında da sigaranın endokrin sistem üzerine etkilerinin değerlendirildiği çalışmalar derlenmiş ve küresel bir problem haline gelen sigara kullanımı için gerekli önlemlerin alınmasının; gelecek nesillerde sigaranın tetiklediği diyabet, kadın ve erkek üreme sistemi bozuklukları, tiroid hastalıklarının önlenmesine katkı sağlayacağı vurgulanmıştır.

Keywords

• Sigara
• endokrin bozucular
• tiroid
• diyabet
• üreme sistemi

Kaynakça

1. Ake, B., Jerrold, J.H., Susan, J., Karen A.K., Thomas, Z. (2012). State of the Science of Endocrine Distrupting Chemicals.
2. Abdel Fattah, S., Rizk, A.-E., Motawie, A., Abd El-Galil, T., & El Sebaie, M. (2019). Effects of nicotine on rat adrenal gland: crosstalk between oxidative and inflammatory markers, and amelioration by melatonin. Biotechnic & Histochemistry, 94(4), 234-243.
3. Asvold, B. O., Bjoro, T., Nilsen, T. I., & Vatten, L. J. (2007). Tobacco smoking and thyroid function: a population-based study. Arch Intern Med, 167(13), 1428-1432.
4. Bandurska-Stankiewicz, E., Aksamit-Białoszewska, E., Rutkowska, J., Stankiewicz, A., & Shafie, D. (2011). The effect of nutritional habits and addictions on the incidence of thyroid carcinoma in the Olsztyn province of Poland. Endokrynologia Polska, 62(2), 145-150.
5. Baron, J. A., Comi, R. J., Cryns, V., Brinck-Johnsen, T., & Mercer, N. G. (1995). The effect of cigarette smoking on adrenal cortical hormones. J Pharmacol Exp Ther, 272(1), 151-155.
6. Belin, R. M., Astor, B. C., Powe, N. R., & Ladenson, P. W. (2004). Smoke exposure is associated with a lower prevalence of serum thyroid autoantibodies and thyrotropin concentration elevation and a higher prevalence of mild thyrotropin concentration suppression in the third National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab, 89(12), 6077-6086.
7. Bonelli, L., Aste, H., Bovo, P., Cavallini, G., Felder, M., Gusmaroli, R., Morandini, E., Ravelli, P., Briglia, R., & Lombardo, L. (2003). Exocrine pancreatic cancer, cigarette smoking, and diabetes mellitus: a case-control study in northern Italy. Pancreas, 27(2), 143-149.
8. Boyle, P., Maisonneuve, P., Bueno de Mesquita, B., Ghadirian, P., Howe, G. R., Zatonski, W., Baghurst, P., Moerman, C. J., Simard, A., Miller, A. B., Przewoniak, K., McMichael, A. J., Hsieh, C. C., & Walker, A. M. (1996). Cigarette smoking and pancreas cancer: a case control study of the search programme of the IARC. Int J Cancer, 67(1), 63-71.

9. Brown, Q. L., Hasin, D. S., Keyes, K. M., Fink, D. S., Ravenell, O., & Martins, S. S. (2016). Health insurance, alcohol and tobacco use among pregnant and non-pregnant women of reproductive age. Drug and alcohol dependence, 166, 116-124.
10. Bruin, J. E., Petre, M. A., Raha, S., Morrison, K. M., Gerstein, H. C., & Holloway, A. C. (2008). Fetal and neonatal nicotine exposure in Wistar rats causes progressive pancreatic mitochondrial damage and beta cell dysfunction. PloS one, 3(10), e3371.
11. Caturegli, P., De Remigis, A., Ferlito, M., Landek-Salgado, M. A., Iwama, S., Tzou, S. C., & Ladenson, P. W. (2012). Anatabine ameliorates experimental autoimmune thyroiditis. Endocrinology, 153(9), 4580-4587.
12. Clair, C., Bitton, A., Meigs, J. B., & Rigotti, N. A. (2011). Relationships of cotinine and self-reported cigarette smoking with hemoglobin A1c in the U.S.: results from the National Health and Nutrition Examination Survey, 1999-2008. Diabetes care, 34(10), 2250-2255.
13. Diamanti-Kandarakis, E., Bourguignon, J.-P., Giudice, L. C., Hauser, R., Prins, G. S., Soto, A. M., Zoeller, R. T., & Gore, A. C. (2009). Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocrine reviews, 30(4), 293-342.
14. Diamanti-Kandarakis, E., Bourguignon, J. P., Giudice, L. C., Hauser, R., Prins, G. S., Soto, A. M., Zoeller, R. T., & Gore, A. C. (2009). Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocr Rev, 30(4), 293-342.
15. Dietz, P. M., England, L. J., Shapiro-Mendoza, C. K., Tong, V. T., Farr, S. L., & Callaghan, W. M. (2010). Infant morbidity and mortality attributable to prenatal smoking in the US. American journal of preventive medicine, 39(1), 45-52.
16. Donna, P., Amir, M., Atieh, A., Fereidoun, A., & Farzad, H. (2018). Tobacco smoking: findings from 20 years of the Tehran lipid and glucose study.
17. Field, A. E., Colditz, G. A., Willett, W. C., Longcope, C., & McKinlay, J. B. (1994). The relation of smoking, age, relative weight, and dietary intake to serum adrenal steroids, sex hormones, and sex hormone-binding globulin in middle-aged men. J Clin Endocrinol Metab, 79(5), 1310-1316.
18. Flouris, A. D., Metsios, G. S., Jamurtas, A. Z., & Koutedakis, Y. (2008). Sexual dimorphism in the acute effects of secondhand smoke on thyroid hormone secretion, inflammatory markers and vascular function. Am J Physiol Endocrinol Metab, 294(2), E456-462. Fowler, C. D., Turner, J. R., & Imad Damaj, M. (2019). Molecular mechanisms associated with nicotine pharmacology and dependence. Substance Use Disorders, 373-393.
19. Galanti, M., Granath, F., Cnattingius, S., EKBOM‐SCHNELL, A., & Ekbom, A. (2005). Cigarette smoking and the risk of goitre and thyroid nodules amongst parous women. Journal of internal medicine, 258(3), 257-264.
20. Ghanbari, M., Ahmadnia, H., Moradi, M. R., & Khajeh, D. M. (2007). Effect of cigarette smoke on spermatogenesis in rats.
21. Giglia, R., Binns, C. W., Alfonso, H., & Zhan, Y. (2007). Which mothers smoke before, during and after pregnancy? Public health, 121(12), 942-949.
22. Glintborg, D., Mumm, H., Hougaard, D. M., Ravn, P., & Andersen, M. (2012). Smoking is associated with increased adrenal responsiveness, decreased prolactin levels and a more adverse lipid profile in 650 white patients with polycystic ovary syndrome. Gynecological Endocrinology, 28(3), 170-174.
23. Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., Toppari, J., & Zoeller, R. T. (2015). EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocr Rev, 36(6), E1-E150.
24. Gutvirtz, G., & Sheiner, E. (2022). Airway pollution and smoking in reproductive health. Best Pract Res Clin Obstet Gynaecol, 85(Pt B), 81-93.
25. Haire-Joshu, D., Glasgow, R. E., & Tibbs, T. L. (1999). Smoking and diabetes. Diabetes care, 22(11), 1887-1898.
26. Halmenschlager, G., Rossetto, S., Lara, G. M., & Rhoden, E. L. (2009). Evaluation of the effects of cigarette smoking on testosterone levels in adult men. J Sex Med, 6(6), 1763-1772.
27. Hiremagalur, B., & Sabban, E. L. (1995). Nicotine elicits changes in expression of adrenal catecholamine biosynthetic enzymes, neuropeptide Y and immediate early genes by injection but not continuous administration. Brain Res Mol Brain Res, 32(1), 109-115.
28. Holbrook, B. D. (2016). The effects of nicotine on human fetal development. Birth Defects Research Part C: Embryo Today: Reviews, 108(2), 181-192.
29. Jandíková, H., Dušková, M., & Stárka, L. (2017). The influence of smoking and cessation on the human reproductive hormonal balance. Physiological Research, 66, S323-S331.
30. Jee, S. H., Foong, A. W., Hur, N. W., & Samet, J. M. (2010). Smoking and risk for diabetes incidence and mortality in Korean men and women. Diabetes care, 33(12), 2567-2572.
31. Johnston, Z. C., Bellingham, M., Filis, P., Soffientini, U., Hough, D., Bhattacharya, S., Simard, M., Hammond, G. L., King, P., & O’Shaughnessy, P. J. (2018). The human fetal adrenal produces cortisol but no detectable aldosterone throughout the second trimester. BMC medicine, 16(1), 1-16.
32. Kabir, E. R., Rahman, M. S., & Rahman, I. (2015). A review on endocrine disruptors and their possible impacts on human health. Environmental Toxicology and Pharmacology, 40(1), 241-258.
33. Kapoor, D., & Jones, T. (2005). Smoking and hormones in health and endocrine disorders. European journal of endocrinology, 152(4), 491-499.
34. Kato, I., Nomura, A. M., Stemmermann, G. N., & Chyou, P.-H. (1992). A prospective study of gastric and duodenal ulcer and its relation to smoking, alcohol, and diet. American journal of epidemiology, 135(5), 521-530.
35. Kawakami, N., Takatsuka, N., Shimizu, H., & Ishibashi, H. (1997). Effects of smoking on the incidence of non-lnsulin-dependent diabetes mellitus: replication and extension in a japanese cohort of male employees. American journal of epidemiology, 145(2), 103-109.
36. Khalaf, H. A., Ghoneim, F. M., Arafat, E. A., & Mahmoud, E.-H. M. (2017). Histological effect of nicotine on adrenal zona fasciculata and the effect of grape seed extract with or without withdrawal of nicotine. Journal of microscopy and ultrastructure, 5(3), 123-131.
37. Kim, S.-j., Kim, M. J., Yoon, S. G., Myong, J. P., Yu, H. W., Chai, Y. J., Choi, J. Y., & Lee, K. E. (2019). Impact of smoking on thyroid gland: dose-related effect of urinary cotinine levels on thyroid function and thyroid autoimmunity. Scientific reports, 9(1), 1-6.
38. Kimball, L., Kulinskaya, E., Brown, B., Johnston, C., & Farid, N. R. (2002). Does smoking increase relapse rates in Graves’ disease? Journal of endocrinological investigation, 25, 152-157.
39. King, E., Campbell, A., Belger, A., & Grewen, K. (2018). Prenatal nicotine exposure disrupts infant neural markers of orienting. Nicotine and Tobacco Research, 20(7), 897-902.
40. Knudsen, N., Bülow, I., Laurberg, P., Ovesen, L., Perrild, H., & Jørgensen, T. (2002). Association of tobacco smoking with goiter in a low-iodine-intake area. Archives of Internal Medicine, 162(4), 439-443.
41. Kurumu, T. İ. (2023, 02.10.2023). Türkiye Sağlık Araştırması, 2022. TUIK. Retrieved 11 September 2023.
42. Larsson, S. C., & Burgess, S. (2022). Appraising the causal role of smoking in multiple diseases: A systematic review and meta-analysis of Mendelian randomization studies. EBioMedicine, 82.
43. Li, D. (2012). Diabetes and pancreatic cancer. Molecular carcinogenesis, 51(1), 64-74.
44. Lio, S., Napolitano, G., Marinuzzi, G., & Monaco, F. (1989). Role of smoking in goiter morphology and thyrotropin response to TRH in untreated goitrous women. Journal of endocrinological investigation, 12(2), 93-97.
45. Luo, J., Rossouw, J., Tong, E., Giovino, G. A., Lee, C. C., Chen, C., Ockene, J. K., Qi, L., & Margolis, K. L. (2013). Smoking and diabetes: does the increased risk ever go away? Am J Epidemiol, 178(6), 937-945.
46. Maddatu, J., Anderson-Baucum, E., & Evans-Molina, C. (2017). Smoking and the risk of type 2 diabetes. Translational Research, 184, 101-107.
47. Manjer, J., Johansson, R., & Lenner, P. (2005). Smoking as a determinant for plasma levels of testosterone, androstenedione, and DHEAs in postmenopausal women. Eur J Epidemiol, 20(4), 331-337.
48. McDonald, S. D., Walker, M., Perkins, S., Beyene, J., Murphy, K., Gibb, W., & Ohlsson, A. (2006). The effect of tobacco exposure on the fetal hypothalamic–pituitary–adrenal axis. BJOG: An International Journal of Obstetrics & Gynaecology, 113(11), 1289-1295.
49. Mendelson, J. H., Sholar, M. B., Goletiani, N., Siegel, A. J., & Mello, N. K. (2005). Effects of low-and high-nicotine cigarette smoking on mood states and the HPA axis in men. Neuropsychopharmacology, 30(9), 1751-1763.
50. Mendelson, J. H., Sholar, M. B., Mutschler, N. H., Jaszyna-Gasior, M., Goletiani, N. V., Siegel, A. J., & Mello, N. K. (2003). Effects of intravenous cocaine and cigarette smoking on luteinizing hormone, testosterone, and prolactin in men. Journal of Pharmacology and Experimental Therapeutics, 307(1), 339-348.
51. Miranda, R. A., de Moura, E. G., & Lisboa, P. C. (2020). Tobacco smoking during breastfeeding increases the risk of developing metabolic syndrome in adulthood: Lessons from experimental models. Food and Chemical Toxicology, 111623.
52. Mohamed, M., Sulaiman, S. A., Jaafar, H., & Sirajudeen, K. N. S. (2011). Antioxidant protective effect of honey in cigarette smoke-induced testicular damage in rats. International journal of molecular sciences, 12(9), 5508-5521.
53. Monneret, C. (2017). What is an endocrine disruptor? C R Biol, 340(9-10), 403-405. Muscat, J. E., Stellman, S. D., Hoffmann, D., & Wynder, E. L. (1997). Smoking and pancreatic cancer in men and women. Cancer Epidemiol Biomarkers Prev, 6(1), 15-19.
54. Natali, A., Mondaini, N., Lombardi, G., Del Popolo, G., & Rizzo, M. (2005). Heavy smoking is an important risk factor for erectile dysfunction in young men. International journal of impotence research, 17(3), 227-230.
55. Novaes Soares, P., Silva Tavares Rodrigues, V., Cherem Peixoto, T., Calvino, C., Aparecida Miranda, R., Pereira Lopes, B., Peixoto-Silva, N., Lopes Costa, L., Claudio-Neto, S., & Christian Manhães, A. (2018). Cigarette smoke during breastfeeding in rats changes glucocorticoid and vitamin D status in obese adult offspring. International journal of molecular sciences, 19(10), 3084.
56. Onor, I. O., Stirling, D. L., Williams, S. R., Bediako, D., Borghol, A., Harris, M. B., Darensburg, T. B., Clay, S. D., Okpechi, S. C., & Sarpong, D. F. (2017). Clinical effects of cigarette smoking: epidemiologic impact and review of pharmacotherapy options. International journal of environmental research and public health, 14(10), 1147.
57. Ostgren, C. J., Lindblad, U., Ranstam, J., Melander, A., Rastam, L., Skaraborg, H., & Diabetes, P. (2000). Associations between smoking and beta-cell function in a non-hypertensive and non-diabetic population. Skaraborg Hypertension and Diabetes Project. Diabet Med, 17(6), 445-450.
58. Park, M. G., Ko, K. W., Oh, M. M., Bae, J. H., Kim, J. J., & Moon, D. G. (2012). Effects of smoking on plasma testosterone level and erectile function in rats. The journal of sexual medicine, 9(2), 472-481.
59. Pomerleau, O. F. (1992). Nicotine and the central nervous system: biobehavioral effects of cigarette smoking. The American journal of medicine, 93(1), S2-S7.
60. Puddey, I. B., Vandongen, R., Beilin, L. J., & English, D. (1984). Haemodynamic and neuroendocrine consequences of stopping smoking--a controlled study. Clin Exp Pharmacol Physiol, 11(4), 423-426.
61. Qiu, F., Liang, C.-L., Liu, H., Zeng, Y.-Q., Hou, S., Huang, S., Lai, X., & Dai, Z. (2017). Impacts of cigarette smoking on immune responsiveness: up and down or upside down? Oncotarget, 8(1), 268.
62. Rattan, S., & Flaws, J. A. (2019). The epigenetic impacts of endocrine disruptors on female reproduction across generations. Biology of reproduction, 101(3), 635-644.
63. Rattan, S., Zhou, C., Chiang, C., Mahalingam, S., Brehm, E., & Flaws, J. A. (2017). Exposure to endocrine disruptors during adulthood: consequences for female fertility. Journal of Endocrinology, 233(3), R109-R129.
64. Rimm, E. B., Manson, J. E., Stampfer, M. J., Colditz, G. A., Willett, W. C., Rosner, B., Hennekens, C. H., & Speizer, F. E. (1993). Cigarette smoking and the risk of diabetes in women. American Journal of Public Health, 83(2), 211-214.
65. Sargeant, L. A., Khaw, K. T., Bingham, S., Day, N. E., Luben, R. N., Oakes, S., Welch, A., & Wareham, N. J. (2001). Cigarette smoking and glycaemia: the EPIC-Norfolk Study. European Prospective Investigation into Cancer. Int J Epidemiol, 30(3), 547-554.
66. Sawicka-Gutaj, N., Gutaj, P., Sowinski, J., Wender-Ozegowska, E., Czarnywojtek, A., Brazert, J., & Ruchala, M. (2014). Influence of cigarette smoking on thyroid gland - an update. Endokrynologia Polska, 65(1), 54-62.
67. Shrivastava, V., Pekar, M., Grosser, E., Im, J., & Vigodner, M. (2010). SUMO proteins are involved in the stress response during spermatogenesis and are localized to DNA double-strand breaks in germ cells. Reproduction, 139(6), 999-1010.
68. Sieminska, A., & Jassem, E. (2014). The many faces of tobacco use among women. Medical science monitor: international medical journal of experimental and clinical research, 20, 153.
69. Śliwińska-Mossoń, M., & Milnerowicz, H. (2017). The impact of smoking on the development of diabetes and its complications. Diabetes and Vascular Disease Research, 14(4), 265-276.
70. Soares, P., Miranda, R., Peixoto, T., Caramez, F., Guarda, D., Manhães, A., de Oliveira, E., de Moura, E., & Lisboa, P. (2019). Cigarette smoke during lactation in rat female progeny: Late effects on endocannabinoid and dopaminergic systems. Life sciences, 232, 116575.
71. Soldin, O. P., Goughenour, B. E., Gilbert, S. Z., Landy, H. J., & Soldin, S. J. (2009). Thyroid hormone levels associated with active and passive cigarette smoking. Thyroid, 19(8), 817-823.
72. Sowers, M. F., Beebe, J. L., McConnell, D., Randolph, J., & Jannausch, M. (2001). Testosterone concentrations in women aged 25-50 years: associations with lifestyle, body composition, and ovarian status. Am J Epidemiol, 153(3), 256-264.
73. Svanes, C., Søreide, J., Skarstein, A., Fevang, B., Bakke, P., Vollset, S., Svanes, K., & Søreide, O. (1997). Smoking and ulcer perforation. Gut, 41(2), 177-180.
74. Svartberg, J., & Jorde, R. (2007). Endogenous testosterone levels and smoking in men. The fifth Tromso study. Int J Androl, 30(3), 137-
75. Tang, Z.-R., Xu, X.-L., Deng, S.-L., Lian, Z.-X., & Yu, K. (2020). Oestrogenic endocrine disruptors in the placenta and the fetus. International journal of molecular sciences, 21(4), 1519.
76. Thornton, J., Kelly, S., Harrison, R., & Edwards, R. (2007). Cigarette smoking and thyroid eye disease: a systematic review. Eye, 21(9), 1135-1145.
77. Trummer, H., Habermann, H., Haas, J., & Pummer, K. (2002). The impact of cigarette smoking on human semen parameters and hormones. Human Reproduction, 17(6), 1554-1559.
78. Tweed, J. O., Hsia, S. H., Lutfy, K., & Friedman, T. C. (2012). The endocrine effects of nicotine and cigarette smoke. Trends in Endocrinology & Metabolism, 23(7), 334-342.
79. Tziomalos, K., & Charsoulis, F. (2004). Endocrine effects of tobacco smoking. Clinical endocrinology, 61(6), 664-674.
80. Vestergaard, P. (2002). Smoking and thyroid disorders-a meta-analysis. European journal of endocrinology, 146(2), 153-161.
81. Vestergaard, P., Rejnmark, L., Weeke, J., Hoeck, H. C., Nielsen, H. K., Rungby, J., Laurberg, P., & Mosekilde, L. (2002). Smoking as a risk factor for Graves' disease, toxic nodular goiter, and autoimmune hypothyroidism. Thyroid, 12(1), 69-75.
82. Wang, W., Yang, X., Liang, J., Liao, M., Zhang, H., Qin, X., Mo, L., Lv, W., & Mo, Z. (2013). Cigarette smoking has a positive and independent effect on testosterone levels. Hormones, 12(4), 567-577.
83. Wang, Y., Ji, J., Liu, Y. J., Deng, X., & He, Q. Q. (2013). Passive smoking and risk of type 2 diabetes: a meta-analysis of prospective cohort studies. PloS one, 8(7), e69915.
84. Wiersinga, W. M. (2013). Smoking and thyroid. Clinical endocrinology, 79(2), 145-151.
85. Wilkins, J. N., Carlson, H. E., Van Vunakis, H., Hill, M. A., Gritz, E., & Jarvik, M. E. (1982). Nicotine from cigarette smoking increases circulating levels of cortisol, growth hormone, and prolactin in male chronic smokers. Psychopharmacology (Berl), 78(4), 305-308.
86. Windham, G. C., Elkin, E. P., Swan, S. H., Waller, K. O., & Fenster, L. (1999). Cigarette smoking and effects on menstrual function. Obstet Gynecol, 93(1), 59-65.
87. Yeh, J., & Barbieri, R. L. (1989). Twenty-four-hour urinary-free cortisol in premenopausal cigarette smokers and nonsmokers. Fertil Steril, 52(6), 1067-1069.
88. Zheng, W., McLaughlin, J. K., Gridley, G., Bjelke, E., Schuman, L. M., Silverman, D. T., Wacholder, S., Co-Chien, H. T., Blot, W. J., & Fraumeni, J. F., Jr. (1993). A cohort study of smoking, alcohol consumption, and dietary factors for pancreatic cancer (United States). Cancer Causes Control, 4(5), 477-482.