Incidental and Progressive Tobacco Smoking in Childhood and Subsequent Risk of Premature Cardiac Damage

Abstract

Section snippets

Methods

The ALSPAC birth cohort investigates factors that influence childhood development and growth.⁵ Of the original cohort of 14,901 children enrolled in the ALSPAC, 4,026 (27%) attended the clinic visit at 24 years of age. Of these, 1,958 (49%) had echocardiograms performed. The current analysis included 1,931 young adults with complete smoking and echocardiographic measures at age 24 years, of whom 890 had echocardiograms at both the 17- and 24-year visits. Ethical approval for the study was

Cohort Study Characteristics

Among 1,931 children (mean age 10.6 ± 0.26 years; 1,211 [62.7%] female]), the prevalence of smoking was 0.3%, 1.6%, 13.6%, 24%, and 26.4% at ages 10, 13, 15, 17, and 24 years, respectively. Sixty percent of children and adolescents who initiated tobacco smoking at ages 10, 13, 15, or 17 years continued smoking at age 24 years. The prevalence of LV hypertrophy increased from 2.8% at age 17 years to 7.5% at age 24 years while LVD dysfunction prevalence increased from 10.4% to 16.9%. Persistent

Discussion

In a large population of apparently healthy children prospectively observed for 14 years from age 10 years through 24 years, persistent smoking from childhood was associated with the odds of premature cardiac functional and structural injury. Cigarette smoke has been associated with endothelial dysfunction and inflammation-induced atherosclerotic processes, abnormal lipid metabolism, increased myocardial hypoxia and oxygen demand, decreased cerebral oxygen availability, and altered metal

Conclusions

Tobacco smoking from childhood through young adulthood was prospectively associated with 33% to 52% odds of premature structural and functional cardiac injury. Cigarette smoking from childhood was associated with cardiac mass increase, and one-third of the effect estimate was retained after controlling for competing risk factors.

Funding Support and Author Disclosures

The UK Medical Research Council and Wellcome (grant reference number 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. The British Heart Foundation grant (CS/15/6/31468) funded blood pressure and Actigraph activity monitoring device measurement at 24 years. The Medical Research Council grant (MR/M006727/1) supported smoking data collection. A comprehensive list of grant funding is available on the ALSPAC website. Dr Agbaje's research group (UndeRstanding FITness and

Acknowledgments

The author is extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses.The informed consent obtained from ALSPAC (Avon Longitudinal Study of Parents and Children) participants does not allow the data to be made freely available through any third-party