I was diagnosed with secondary polycythemia 16 years ago. I am a smoker but smoke at the most a pack a day years ago. I am quitting... My question is, could my 1/2 a pack a day smoking habit cause Secondary PV? The mayo clinic finally diagnosed me as having stress PV after every test ran they could think of came back normal. I am a 40 year old female. Any thoughts or ideas would be greatly appreciated. I have been suffering from extreme fatigue for quite some time. I need my life back for my kids, husband and me!!!