Acta Medica Iranica 2017. 55(6):389-394.

Smoking Discriminately Changes the Serum Active and Non-Active Forms of Vitamin B12
Niloofar Shekoohi, Mohammad Hassan Javanbakht, Marjan Sohrabi, Mahnaz Zarei, Hamed Mohammadi, Mahmoud Djalali


Smoking may modify the appetite, and consequently affect nutrient intake and serum micronutrients. The effect of smoking on vitamin B12 status has been considered in several studies. The research proposed that organic nitrites, nitro oxide, cyanides, and isocyanides of cigarette smoke interfere with vitamin B12 metabolism, and convert it to inactive forms. This research was carried out to determine the serum level of active and inactive forms of vitamin B12 in male smokers in comparison with male nonsmokers. This is a case-control study, in which the participants were 85 male smokers and 85 male nonsmokers. The serum levels of total and active form of vitamin B12 were measured. Dietary intake was recorded by a quantitative food frequency questionnaire and one-day 24-hour dietary recall method. Independent two sample T test was used to compare quantitative variables between the case and control groups. The serum level of total vitamin B12 was not significantly different between two groups, but serum level of active form of vitamin B12 in the smoking group was significantly lower than non-smoking group (P<0.001). This is one of the first studies that evaluated the serum level of active form of vitamin B12 in smokers in the Iranian community. The results of this study identified that serum level of total vitamin B12 might be not different between smoking and non-smoking people, but the function of this vitamin is disturbed in the body of smokers through the reduction of serum level of active form of vitamin B12.


Smoking; Active form; Non-active form; Vitamin B12

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Pericas J, Gonzalez S, Bennasar M, De Pedro J, AguiloA, Bauza L. Cognitive dissonance towards the smoking habit among nursing and physiotherapy students at theUniversity of Balearic Islands in Spain. Int Nurs Rev2009;56:95-101.

WHO. World Health Organization. Tobacco (fact sheetno 339). (Accessed March 2017, 12, at Northrop-Clewes CA, Thurnham DI. Monitoringmicronutrients in cigarette smokers. Clin Chim Acta2007;377:14-38.

McPhillips JB, Eaton CB, Gans KM, Derby CA, LasaterTM, McKenney JL, et al. Dietary differences in smokersand nonsmokers from two southeastern New Englandcommunities. J Am Diet Assoc 1994;94:287-92.

Piyathilake CJ, Macaluso M, Hine RJ, Richards EW,Krumdieck CL. Local and systemic effects of cigarettesmoking on folate and vitamin B-12. Am J Clin Nutr1994;60:559-66.

Khaled MA, Watkins CL, Krumdieck CL. Inactivation ofB 12 and folate coenzymes by butyl nitrite as observed byNMR: Implications on one-carbon transfer mechanism.Biochem Biophys Res Commun. 1986;135:201-7.

Mushett CW, Kelley KL, Boxer GE, Rickards JC.Antidotal efficacy of vitamin B12a (hydroxo-cobalamin)in experimental cyanide poisoning. Exp Biol Med(Maywood) 1952;81:234-7.

Pagán K, Hou J, Goldenberg RL, Cliver SP, Tamura T.Effect of smoking on serum concentrations of totalhomocysteine and B vitamins in mid-pregnancy. ClinChim Acta 2001;306:103-9.

Ghaffarpour M, Houshiar-Rad A, Kianfar H. The manualfor household measures, cooking yields factors and edibleportion of foods. Tehran: Keshavarzi Press, 1999.

Haghighatdoost F, Karimi G, Esmaillzadeh A, AzadbakhtL. Sleep deprivation is associated with lower diet qualityindices and higher rate of general and central obesityamong young female students in Iran. Nutrition2012;28:1146-50.

Fung TT, Hu FB, Pereira MA, Liu S, Stampfer MJ,Colditz GA, et al. Whole-grain intake and the risk of type2 diabetes: a prospective study in men. Am J Clin Nutr2002;76:535-40.

Iqbal MP, Yakub M. Smokeless tobacco use: a risk factorfor hyperhomocysteinemia in a Pakistani population. PloSOne 2013;8:e83826.

Kim DB, Oh YS, Yoo KD, Lee JM, Park CS, Ihm SH, etal. Passive Smoking in Never-Smokers Is AssociatedWith Increased Plasma Homocysteine Levels Analysis ofNHANES III Data. Int Heart J 2010;51:183-7.

Gariballa S, Forster S. Associations between smoking,nutritional status and clinical outcome following acuteillness. Eur J Intern Med 2008;19:S4.

Vardavas CI, Linardakis MK, Hatzis CM, Malliaraki N,Saris WH, Kafatos AG. Smoking status in relation toserum folate and dietary vitamin intake. Tob Induc Dis2008;4:8.

Ozerol E, Ozerol I, Gökdeniz R, Temel I, Akyol O. Effectof smoking on serum concentrations of totalhomocysteine, folate, vitamin B12, and nitric oxide inpregnancy: a preliminary study. Fetal Diagn Ther2003;19:145-8.

Mouhamed DH, Ezzaher A, Neffati F, Douki W, NajjarMF. Effect of cigarette smoking on plasma homocysteineconcentrations. Clin Chem Lab Med 2011;49:479-83.

Tungtrongchitr R, Pongpaew P, Soonthornruengyot M, etal. Relationship of tobacco smoking with serum vitaminB12, folic acid and haematological indices in healthyadults. Public Health Nutr 2003;6:675-81.

Lindstrand K, Wilson J, Matthews D. Chromatographyand microbiological assay of vitamin B12 in smokers.BMJ 1966;2:988-90.

Matthews D, Wilson J, Zilkha K. Cyanide metabolismand vitamin B12 in multiple sclerosis. J NeurolNeurosurg Psychiatry 1965;28:426-8.21. Benowitz NL. Cotinine as a biomarker of environmentaltobacco smoke exposure. Epidemiol Rev 1996;18:188-204.

Benowitz NL. Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiol Rev 1996;18:188-04.


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