Childhood Environmental Tobacco Smoke Exposure

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