The effects of heat-not-burn tobacco products, cigarette smoking, and alcohol use lowered the antibody response to the Pfizer BNT162b2 vaccine.
That’s the summary of the study from Tokyo, Japan. The study was published recently at medRxiv.
The goal of the Pfizer COVID vaccine is to increase the antibodies against the spike protein of the SARS-CoV-2 and provide immunity against COVID-19. It has been known before that smoking and heavy alcohol drinking can affect the immune system.
This is the first study that evaluated antibody response after the Pfizer Biontech vaccine among people who use heat-not-burn tobacco products, smokers, and alcohol drinkers.
Before we go to the results, let us know more about heated tobacco products (HTP), go, and geometric mean.
What are Heat-not-burn tobacco products?
Heat-not-burn (HNB) or Heated tobacco products are electronic devices that heat the tobacco to emit nicotine that goes into the lungs. They do not burn tobacco compared to cigarettes.
Heated tobacco products are harmful, especially to the youth, young adults, and pregnant women.
HNB is different from e-cigarettes. E-cigarettes are electronic devices that vaporize a liquid containing nicotine, flavorings, and other ingredients.
GO as a measure of alcohol consumption
In the study, alcohol consumption was measured as go/day. In Japan, go (180 mL) is used as the conventional unit to measure alcohol amount; 1 go of Japanese sake contains approximately 23 g of ethanol, which is equivalent to
- 500 mL of beer
- 110 mL of shochu (25% alcohol content). Shochu is a Japanese distilled beverage.
- Double (60 mL) of whisky, or
- 180 mL of wine.
The geometric mean is a measure of antibody response in this study.
What is a geometric mean?
Antibody titers are usually measured on a logarithmic scale because serial dilutions are needed, e.g., 2x, 4x,8x, 16x, or 10x, 100x,1000x. The resulting logarithmic numbers are long and can be confusing. The results are simplified by converting to geometric mean titer (GMT). More about GMT here.
Suffice it to say that for this study, the lower the GMT, the lower the antibody titer.
The study included 3,457 healthcare workers fully vaccinated with the Pfizer Biontech vaccine. The study excluded e-cigarette users.
Results:
antibody levels after Pfizer BNT162b2 among Non-smokers, Heat-Not-BURN, and cigarette users
- Never-smokers (never smoked a cigarette and did not use HNB tobacco products)
GMT-119 - Exclusive HNB tobacco users GMT-103)
- Dual users of HNB and cigarettes GMT- 105
- Exclusive cigarettes smokers GMT=96
- <11 cigarettes per day – GMT – 104
- ≥11 cigarettes per day – GMT – 92
Antibody levels after Pfizer BNT162b2 with Alcohol use
Weekly drinkers of alcoholic beverages had significantly lower antibody titers than
non-drinkers. Spike IgG antibody titers steadily decreased with the increasing amount of alcohol consumption.
- Non-alcohol drinkers GMT-123
- Alcohol drinkers consuming <1 go/day GMT-114
- 1–1.9 go/day GMT-105
- ≥2 go/day GMT-101
The graph below shows the decreasing amounts of anti-spike antibodies produced with increasing doses of alcohol consumption.
Know that the amount of alcohol in a Japanese drink, which is 23 gms of ethanol, is higher than in other countries.
Alcohol amounts per standard drink vary per country
Levels of alcohol per drink differ among countries. In the US, a standard drink roughly contains 14 grams of alcohol.
European countries have different grams of alcohol in a standard drink. For example, the UK has 8 gms, and Austria has 20 grams of alcohol per drink.
Take away Message
Using heat-not-burn (HNB) tobacco products and cigarette smoking, moderate and high-dose alcohol is associated with decreased vaccine-induced antibody levels. The immune system does not differentiate between vaccine manufacturers or variants.
Smokers and alcohol drinkers also have lower antibody responses in COVID-19 disease, resulting in poor outcomes.
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References:
- Yamamoto et al. Use of heat-not-burn tobacco products, moderate alcohol drinking, and anti-SARS-CoV-2 IgG antibody titers after BNT162b2 vaccination among Japanese healthcare workers
- Leigh, James. (2015). Re: Why do we use geometric mean concentration for antibody titer?. Retrieved from: https://www.researchgate.net/post/Why-do-we-use-geometric-mean-concentration-for-antibody-titer/562068b86307d9ec4f8b4567/citation/download.
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