Key Takeaways:
- Tobacco smoking from childhood to young adulthood is linked to significant cardiac damage by age 24.
- Over half of children who began smoking at age 10 continued smoking into young adulthood.
- Persistent smoking from childhood to early adulthood results in potential irreversible cardiac injury by age 24, according to research findings.
Study Overview:
Andrew Agbaje, MD, MPH, PhD, associate professor at the University of Eastern Finland, analyzed data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort study focused on childhood development in England. The study assessed the long-term effects of early smoking on heart health, and the findings were published in the Journal of the American College of Cardiology.
Dr. Agbaje explained the need to study the effects of smoking on the heart during growth phases, emphasizing that while smoking is a known risk factor for cancer and heart disease, most studies focus on adults. “By the time we link smoking to a heart attack at 45 years, damage has been accumulating for decades,” he said.
Agbaje stressed that understanding early cardiac injury caused by smoking could encourage caution among young smokers, as damage might already begin during adolescence.
Prevalence of Smoking in Youth:
The ALSPAC cohort included 1,931 participants with echocardiographic data at age 24, and 890 of them had data at ages 17 and 24. Smoking prevalence increased dramatically:
- Age 10: 0.3%
- Age 13: 1.6%
- Age 15: 13.6%
- Age 17: 24%
- Age 24: 26.4%
Notably, 60% of those who started smoking at age 10, 13, 15, or 17 continued smoking at age 24. Agbaje highlighted the critical window to intervene between ages 13 and 17 when smoking rates rapidly escalate.
Cardiac Impacts of Persistent Smoking:
After adjusting for various factors like socioeconomic status, physical activity, and family history, persistent smoking from childhood was associated with:
- Left ventricular hypertrophy (OR = 1.52; P < .001)
- High relative wall thickness (OR = 1.38; P < .001)
- LV diastolic dysfunction (OR = 1.33; P < .001)
- High left ventricular filling pressure (OR = 1.35; P < .001)
Agbaje described the situation as a “time bomb,” stressing that cardiac damage begins decades before symptoms like heart attacks or heart failure manifest. He argued for preventive measures, including bold public health initiatives to address tobacco use among youth.
Public Health Message:
Agbaje called for governments to act decisively to curb tobacco use among children, noting that the healthcare costs of treating tobacco-related illnesses far outweigh revenue from tobacco taxes. “The future of every nation is its children,” he said. “If they die before us, what happens to our nation? Tobacco is the dilemma of the century—let’s save the kids.”
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