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Am J Obstet Gynecol. 1979 Dec 15;135(8):1012-5.

The effect of smoking and oral contraceptives on the urinary excretion of epinephrine and norepinephrine.


Eight smokers and seven nonsmokers between the ages of 20 and 38 years were studied. None of these patients was pregnant. Three smokers and two nonsmokers were not taking oral contraceptives, as contrasted by three nonsmokers and four smokers taking oral contraceptives. Results approached statistical significance for urinary norepinephrine (p = 0.15) and epinephrine (p = 0.07) when the groups were compared. The values for nonsmoking/noncontraception tended to be low but, unexpectedly, the values for smoking/contraception also were low. When the smoking subjects (six of seven) stopped there was a significant decline in norepinephrine (p = 0.02) and the epinephrine decline approached significance (p = 0.08). The study does not show any synergistic effect of oral contraceptives and smoking but demonstrates that the smoker can diminish stimulation of the adrenal gland (epinephrine) and sympathetic nervous system (norepinephrine) if she will stop smoking.


Cigarette smoking is known to increase: 1) adrenal medullary hormone secretion (epinephrine); 2) sympathetic nervous system activity as shown by an increase in norepinephrine; and, 3) risk of myocardial infarction among oral contraceptive (OC) users. This study analyzes the interaction of OCs in smoking women because nicotine and OCs may interact and change the woman's neurohormonal excretion. 15 subjects (8 smokers and 7 nonsmokers) aged 20-38 years and who were not pregnant participated in the study. 12-hour-urine samples were collected 3 times a week for 8 weeks. The method of Zuspan and Cooley was used to measure the urinary amines (epinephrine, norepinephrine). The results of the analysis were statistically significant for both norepinephrine (p=0.15) and epinephrine (p=0.07). The values for nonsmoking/noncontraception were low, but so were those for smoking/contraception. When 6 of 7 smokers stopped smoking, a significant decline in norepinephrine (p=0.02) was observed. The decline for epinephrineapproached significant levels (p=0.08). The findings of this study establish an association between smoking and oral contraception in that there is an increase in urinary norepinephrine for patients not taking OCs but the smoker has an increase in norepinephrine twice that of nonsmokers, Too, for smokers, urinary excretion shows a 50% increase in epinephrine, suggesting that both the adrenal gland and sympathetic nervous system are affected by nicotine. Although this study does not suggest a synergistic relationship between smoking and oral contraception, it shows that both the adrenal gland and sympathetic nervous system's responses will be lowered if nicotine is curtailed.

[Indexed for MEDLINE]

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