Parental smoking produces long-term damage to vascular function in their children

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Purpose of review

This review provides an overview of recent findings concerning the cardiovascular effects of childhood exposure to environmental tobacco smoke (ETS).

Recent findings

Epidemiological studies have shown that childhood ETS exposure is associated with increased occurrence of several cardiovascular risk factors, including obesity, elevated blood pressure, dyslipidemia and metabolic syndrome. Several cross-sectional analyses have found that ETS adversely affects arterial structure (increased intima–media thickness) and function (decreased elasticity and endothelial function). In addition, recent findings suggest that individuals exposed in childhood have significantly reduced brachial artery endothelial function 20 years later in adulthood. Importantly, this effect could not be explained by adult risk factor levels or smoking behaviors. So far, results from intervention studies to promote parental smoking cessation have been disappointing, with an average success rate of less than 25% in intervention studies.


Childhood ETS exposure is strongly associated with both cardiovascular risk factors and subclinical markers of atherosclerosis. As present, intervention strategies for parental smoking cessation seem inadequate; there is an urgent need for innovative intervention strategies to protect children from the detrimental effects of ETS.

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