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

Eur Heart J. 2014 Sep 21;35(36):2484-91. doi: 10.1093/eurheartj/ehu049. Epub 2014 Mar 4.


Aim: Recent evidence suggests that the exposure of children to their parents' smoking adversely effects endothelial function in adulthood. We investigated whether the association was also present with carotid intima-media thickness (IMT) up to 25 years later.

Methods and results: The study comprised participants from the Cardiovascular Risk in Young Finns Study (YFS, n = 2401) and the Childhood Determinants of Adult Health (CDAH, n = 1375) study. 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. Linear regression on a pooled dataset accounting for the hierarchical data and potential confounders including age, sex, parental education, participant smoking, education, and adult cardiovascular risk factors was conducted. 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 ± SE) 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.

Conclusions: These results show the pervasive effect of exposure to parental smoking on children's vascular health up to 25 years later. There must be continued efforts to reduce smoking among adults to protect young people and to reduce the burden of cardiovascular disease across the population.

Keywords: Cardiovascular diseases; Children; Epidemiology; Passive smoking; Risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Carotid Intima-Media Thickness / statistics & numerical data
  • Child
  • Child, Preschool
  • Female
  • Finland / epidemiology
  • Humans
  • Male
  • Parents
  • Prospective Studies
  • Risk Factors
  • Tobacco Smoke Pollution / adverse effects*


  • Tobacco Smoke Pollution