The effect of stopping smoking on cervical Langerhans' cells and lymphocytes

Objective To investigate the effects of stopping smoking on cervical Langer hans' cells and lymphocytes. Design Prospective intervention study. Setting A large family planning clinic in central London. Population Women volunteers prepared to attempt to give up smoking for six months. Their most recent cervical smear showed no abnormality greater than mild dyskaryosis. Methods The women were seen at three-month intervals fur sis months. Reduct ion in smoking was assessed by self-reporting and validated bl salivary cot inine concentrations. Colposcopy and a biopsy of a normal area were perform ed at the first and last visits. Any area of abnormality was also biopsied at the final visit. Langerhans' cells and lymphocytes were counted. Main outcome measures Proportional changes in counts of Langerhans' cells a nd lymphocytes with reduction in smoking. Results Reduction in smoking by 20 to 40 cigarettes per day was significant ly associated with a reduction of between 6% and 16% in counts of Langerhan s cells, CDS and total lymphocytes. Heavy smoking was significantly associa ted (P = 0.02) with an increased chance of persistent human papillomavirus infection. The presence of candida was associated with significantly higher counts of between 41% and 47% in total lymphocytes and CDS lymphocytes. In contrast, the presence of anaerobic vaginosis was associated with signific antly lower counts of between 16% and 30t7c in Langerhans cells, CD4 and CD 8 lymphocytes. Conclusions This large intervention study has demonstrated a clear relation ship between reduction in smoking and changes in cervical immune cell count s. Future studies need to take into account cytokine interactions, which re cent studies suggest may be significant in the immune response to both huma n papillomavirus and cervical intraepithelial neoplasia and the ever-increa sing complexity of the cell-mediated immune system of the cervix.