Fibrinogen and cigarette smoking in men and women in the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) population

Eur J Cardiovasc Prev Rehabil. 2005 Apr;12(2):144-50. doi: 10.1097/01.hjr.0000140719.09768.e2.


Background: Plasma fibrinogen may be an independent risk factor for cardiovascular disease. Cigarette smoking is a well-recognized determinant of plasma fibrinogen however it remains unclear how fibrinogen levels relate to the degree and duration of smoking, or to time since smoking cessation.

Methods: In a population-based study of 11 059 men and women aged 45-74 years, we examined the cross-sectional relationship between plasma fibrinogen and cigarette smoking habit.

Results: Mean fibrinogen concentrations were higher in current smokers compared to non-current smokers (men: 3.13+/-0.77 versus 2.80+/-0.71 g/l, P<0.0001; women: 3.03+/-0.72 versus 2.95+/-0.71 g/l, P=0.01), independent of age, body mass index and hormone replacement therapy in women In men, fibrinogen concentrations declined with years since stopping smoking but remained higher than in life-long non-smokers for 15 years. No relationship between fibrinogen and duration of smoking cessation was observed in women. On multivariate analysis, age, body mass index, use of hormone-replacement therapy, smoking status and pack-years of smoking were independent predictors of plasma fibrinogen.

Conclusions: Plasma fibrinogen is strongly associated with cigarette smoking with a dose-response relationship with total pack-years of smoking. In men who stop smoking plasma fibrinogen may remain elevated for several years after cessation.

Publication types

  • Comparative Study

MeSH terms

  • Age Distribution
  • Aged
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology*
  • Confounding Factors, Epidemiologic
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Female
  • Fibrinogen / analysis*
  • Health Surveys
  • Humans
  • Incidence
  • Life Style
  • Male
  • Middle Aged
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Smoking / adverse effects*
  • Smoking Cessation
  • Survival Analysis


  • Fibrinogen