Exposure to Parental Smoking in Childhood or Adolescence Is Associated With Increased Carotid Intima-Media Thickness in Young Adults: Evidence From the Cardiovascular Risk in Young Finns Study and the Childhood Determinants of Adult Health Study

Study Questions:

Does parental smoking exposure increase carotid intima-media thickness (IMT) in young adults?


Data from the Cardiovascular Risk in Young Finns Study (n = 2,401) and the Childhood Determinants of Adult Health study (n = 1,375) were used for the present analysis. For the Young Finns Study, information on exposure to parental smoking was collected at baseline (1980), while adult carotid IMT measures were collected in 2001 or 2007. These measures were included from 72% of eligible participants who were ages 3, 6, 9, 12, 15, or 18 years old at baseline. The analyses of the association between cumulative exposure to parental smoking from 1980 to 1983, and adult carotid IMT in 2001 or 2007, included 2,041 individuals. For the Childhood Determinants of Adult Health study, (conducted in Australia), IMT measurements were completed in 23% of eligible participants who were ages 9-15 years at baseline (1985), and who completed carotid IMT studies between 2004 and 2006 (age range, 26-36 years). Exposure to parental smoking (none, one, or both) was assessed at baseline by questionnaire. B-mode ultrasound of the carotid artery determined IMT in adulthood.


Carotid IMT in adulthood was greater in those exposed to both parents smoking than in those whose parents did not smoke (adjusted marginal means: 0.647 mm ± 0.022 [mean ± standard error] vs. 0.632 mm ± 0.021, p = 0.004). Having both parents smoke was associated with vascular age 3.3 years greater at follow-up than having neither parent smoke. The effect was independent of participant smoking at baseline and follow-up and other confounders, and was uniform across categories of age, sex, adult smoking status, and cohort. There was no evidence that adult smoking status was an effect modifier of the association between parental smoking in childhood and adult carotid IMT. Greater exposure to smokers in the home was associated with a significantly greater carotid IMT in adulthood even after adjusting for all relevant confounding factors.


The investigators concluded that the pervasive effect of exposure to parental smoking on children’s vascular health up to 25 years later is significant.


Data from two large, long-term cohorts provide strong evidence that parental smoking affects the long-term vascular health of children in the home. Presenting such evidence when educating parents on the impact of smoking is recommended.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Noninvasive Imaging, Prevention, CHD and Pediatrics and Imaging, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Echocardiography/Ultrasound, Smoking

Keywords: Child, Carotid Artery, Common, Follow-Up Studies, Carotid Intima-Media Thickness, Australia, Cardiovascular Diseases, Risk Factors, Tobacco Use Disorder, Smoking

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