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Children exposed to secondhand smoke at home at greater risk for AF
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Children who were exposed to secondhand smoke by a parent not only had a significantly higher risk for developing atrial fibrillation but also were more likely to begin smoking themselves.
According to a study published in the Journal of the American College of Cardiology, researchers studying Framingham Offspring cohort participants with parents in the original cohort observed that for every pack per day increase in parental smoking, there was an 18% increase in offspring AF incidence (adjusted HR = 1.18; 95% CI, 1-1.39).
Moreover, offspring with at least one smoking parent experienced a greater risk for smoking themselves (aOR = 1.34; 95% CI, 1.17-1.54).
“These data show that parental smoking influences the risk of AF among offspring, demonstrating chronic deleterious effects that are relevant decades after the initial exposure,” Christopher A. Groh, MD, clinical fellow of the division of cardiology at the University of California, San Francisco, and colleagues wrote. “These observations reveal an association between an early life exposure and AF, which may suggest that new mechanistic pathways for AF risk are deserving of further exploration.”
In other findings, the relationship between parental smoking and offspring AF was mediated by 17% (95% CI, 1.5-103.3) by the occurrence of offspring smoking.
“As the world experiences an increasing burden of AF, it is imperative to identify AF risk factors beyond traditional cardiovascular comorbidities and ideally to highlight lifestyle factors that can be readily modified,” the researchers wrote. “Smoking remains the most important modifiable cause of death and morbidity in the world, and new information regarding the harms of secondhand smoke may prove useful to motivate smoking cessation and avoidance.”
Participants of the Framingham cohort were evaluated every 2 to 8 years and consistently assessed for incident AF. Offspring of participants of the original cohort were evaluated for AF until aged 18 years. Researchers also performed a mediation analysis using data from the offspring included in the analysis (parental smoking, n = 2,316; mean age, 33 years; 48% men; 48% with smoking history; no parental smoking, n = 500; mean age, 30 years; 53% men; 37% with smoking history) to determine any relationship between offspring smoking and any of the observed associations.
“Whether related to acute smoke inhalation during development and/or learned behaviors that influence risk later in life, these observations may provide new evidence to motivate current smokers to quit and potential smokers to avoid smoking altogether,” the researchers wrote.
“Although the adoption of smoke-free policies in the United States has reduced workplace exposure to secondhand smoke and made most public places smoke-free, persons may not be aware of the risk of exposure to secondhand smoke in other places, such as the home or the car,” Alanna M. Chamberlain, PhD, MPH, epidemiologist in the department of health sciences research at Mayo Clinic, wrote in a related editorial. “Thus, clinicians should not miss an opportunity to discuss the harms of secondhand smoke with their patients, to emphasize to parents who smoke to change their smoking behaviors and reduce secondhand smoke exposure in their children, and to recommend nonsmokers to avoid exposure to secondhand smoke to reduce their cardiovascular risk.” – by Scott Buzby
Disclosures: Groh and Chamberlain report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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