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We investigated the association of smoking with blood cells in the Danish General Suburban Population Study (GESUS, <jats:italic>n<\/jats:italic>\u00a0=\u00a011\u00a0083), by meta\u2010analyses (including GESUS) of 92 studies (<jats:italic>n<\/jats:italic>\u00a0=\u00a0531\u00a0741) and MR of smoking variant <jats:italic>CHRNA3<\/jats:italic> (rs1051730[A]) in UK Biobank, and with MPN in a meta\u2010analysis of six studies (<jats:italic>n<\/jats:italic> (total\/cases):1\u00a0425\u00a0529\/2187), totalling 2\u00a0307\u00a0745 participants. In the meta\u2010analysis the random\u2010effects standardized mean difference (SMD) in current smokers <jats:italic>versus<\/jats:italic> non\u2010smokers was 0\u00b782 (0\u00b775\u20130\u00b789, <jats:italic>P<\/jats:italic>\u00a0=\u00a02\u00b70\u00a0*\u00a010<jats:sup>\u2212108<\/jats:sup>) for leukocytes, 0\u00b709 (\u22120\u00b702 to 0\u00b721, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b712) for erythrocytes, 0\u00b753 (0\u00b742\u20130\u00b764, <jats:italic>P<\/jats:italic>\u00a0=\u00a08\u00b70\u00a0*\u00a010<jats:sup>\u221222<\/jats:sup>) for haematocrit, 0\u00b742 (0\u00b734\u20130\u00b751, <jats:italic>P<\/jats:italic>\u00a0=\u00a07\u00b71\u00a0*\u00a010<jats:sup>\u221221<\/jats:sup>) for haemoglobin, 0\u00b719 (0\u00b708\u20130\u00b731, <jats:italic>P<\/jats:italic>\u00a0=\u00a01\u00b72\u00a0*\u00a010<jats:sup>\u22123<\/jats:sup>) for mean corpuscular haemoglobin (MCH), 0\u00b729 (0\u00b719\u20130\u00b739, <jats:italic>P<\/jats:italic>\u00a0=\u00a01\u00b76\u00a0*\u00a010<jats:sup>\u22128<\/jats:sup>) for mean corpuscular volume (MCV), and 0\u00b704 (\u22120\u00b704 to 0\u00b713, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b734) for platelets with trends for ever\/ex\u2010\/current smokers, light\/heavy smokers and female\/male smokers. Analyses presented high heterogeneity but low publication bias. Per allele in <jats:italic>CHRNA3<\/jats:italic>, cigarettes per day in current smokers was associated with increased blood cell counts (leukocytes, neutrophils), MCH, red cell distribution width (RDW) and MCV. The pooled fixed\u2010effects odds ratio for MPN was 1\u00b744 [95% confidence interval\u00a0(CI): 1\u00b733\u20131\u00b756; <jats:italic>P<\/jats:italic>\u00a0=\u00a01\u00b78\u00a0*\u00a010<jats:sup>\u221219<\/jats:sup>; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%] in current smokers, 1\u00b729 (1\u00b715\u20131\u00b744; <jats:italic>P<\/jats:italic>\u00a0=\u00a08\u00b70\u00a0*\u00a010<jats:sup>\u22126<\/jats:sup>; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%) in ex\u2010smokers, 1\u00b749 (1\u00b726\u20131\u00b777; <jats:italic>P<\/jats:italic>\u00a0=\u00a04\u00b74\u00a0*\u00a010<jats:sup>\u22126<\/jats:sup>; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%) in light smokers and 2\u00b704 (1\u00b774\u20132\u00b739, <jats:italic>P<\/jats:italic>\u00a0=\u00a02\u00b73\u00a0*\u00a010<jats:sup>\u221218<\/jats:sup>; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a051%) in heavy smokers compared with non\u2010smokers. Smoking is observationally and genetically associated with increased leukocyte counts\u00a0and red blood cell indices (MCH, MCV, RDW)\u00a0and observationally with risk of MPN in current and ex\u2010smokers versus non\/never\u2010smokers.<\/jats:p>","DOI":"10.1111\/bjh.16321","type":"journal-article","created":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T05:19:52Z","timestamp":1577337592000},"page":"323-334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Smoking, blood cells and myeloproliferative neoplasms: meta\u2010analysis and Mendelian randomization of 2\u00b73 million people"],"prefix":"10.1111","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0688-3161","authenticated-orcid":false,"given":"Nimesh A.","family":"Jayasuriya","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Boston Children's Hospital Boston MA USA"},{"name":"School of Medicine University of 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