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Information from examinations of 62,541 adults enrolled in a study of smoking from 1979 through 1982 in Oakland, California, was used to explore the associations of various measures of intensity of smoking with the leukocyte count and to try to determine whether there was a persistent effect of smoking cigarettes on the leukocyte count. In current, regular cigarette smokers, leukocyte counts were higher in smokers of a large number of cigarettes and were associated with smoking cigarettes with a high tar and nicotine yield, deep inhalation of the cigarette smoke, and a longer duration of smoking. There was an association of past smoking with a high leukocyte count independent of age, sex, and race. In past smokers of cigarettes who used no other form of tobacco, the leukocyte count was related to time since quitting, smokers who had quit more recently having higher leukocyte counts. The study shows that a high leukocyte count is associated consistently with various measures of intensity of cigarette smoking. Moreover, it appears that smoking has an effect on the leukocyte count that persists after quitting. Delineation of the physiologic basis for the acute and chronic effects of cigarette smoking on the leukocyte count might lead eventually to a better understanding of the mechanisms for regulation of granulopoiesis and the release and destruction of leukocytes.

Pernicious anemia and pneumonia are pathological states in which the cholesterol content of the blood is known to be altered during the course of the disease. In pernicious anemia, the cholesterol content of the serum is depressed to a varying degree below normal, paralleling the severity of symptoms, the diminution in the erythrocyte content and hemoglobin percentage of the blood. In view of the fact that cholesterol has been shown to possess the property of neutralizing the hemolytic action of various materials, animal and vegetable toxins, an increase in the severity of symptoms in pernicious anemia with the depression of this substance in the blood serum suggests the utilization of this antitoxic property against the unknown hemolytic toxins which are present in the body in this disease.The transfusion of whole blood from a donor whose serum cholesterol content was relatively high, was apparently without permanent influence on the cholesterol content of the serum of the pernicious anaemia patient, regardless of the clinical improvement which was temporarily manifest. It may be that the additional cholesterol added in the infused blood contributes in a degree to the temporary clinical improvement of the patient, although the cholesterol level in the blood serum is maintained at a low figure and is again lowered with a relapse of the symptoms.In pneumonia, the cholesterol in the serum was found to follow a variation dependent upon the severity of the disease, the amount of involvement of the lung tissue and development of the pneumonk exudate in the inflammatory process which follows the bacterial invasion. There is a primary depression of the cholesterol content of the serum in the first few days of the disease. This depression seems to be dependent upon the severity of the disease and particularly upon the degree of involvement of the lung tissue by the inflammatory process.