Childhood environmental tobacco smoke exposure: a smoking gun for atherosclerosis in adulthood.

Abstract

In the 1960s the US Surgeon General and American Heart Association issued reports warning of the dangers of smoking on fatal coronary artery disease.1-3 Since those early publications, 32 US Surgeon General Reports and thousands of studies have been released exposing the harmful effects of cigarette smoking on cardiovascular health.4,5 Yet over a half a century later, the toxic legacy continues to unravel. Cigarette smoking is now well established as a causal risk factor for cardiovascular disease (CVD). Pooled data from almost 1 million people reveals that the risk of ischemic heart disease for current smokers is 2.6 (95%CI 2.4, 2.7) times higher for men and 3.0 (2.8, 3.2) times higher for women compared to nonsmokers.6 Secondhand smoke (SHS) exposure has emerged as a significant risk factor for CVD among nonsmokers, demonstrating a dose-dependent relationship with higher risk of CVD among those with higher SHS exposure.7-9 In epidemiological studies the risk of coronary heart disease among SHS exposed non-smoking adults is 1.25 times (1.17, 1.32) higher than unexposed.10