Secondhand smoke and atrial fibrillation: Data from the Health eHeart Study

Heart Rhythm. 2016 Jan;13(1):3-9. doi: 10.1016/j.hrthm.2015.08.004. Epub 2015 Sep 1.


Background: Cigarette smoking is a risk factor for atrial fibrillation (AF), but whether secondhand smoke (SHS) impacts the risk of AF remains unknown.

Objective: To determine if SHS exposure is associated with an increased risk of AF.

Methods: We performed a cross-sectional analysis of data from participants enrolled in the Health eHeart Study, an internet-based, longitudinal cardiovascular cohort study, who completed baseline SHS exposure and medical conditions questionnaires. SHS was assessed through a validated 22-question survey, and prevalent AF was assessed by self-report, with validation of a subset (n = 42) by review of electronic medical records.

Results: Of 4976 participants, 593 (11.9%) reported having AF. In unadjusted analyses, patients with AF were more likely to have been exposed to SHS in utero, as a child, as an adult, at home, and at work. After multivariable adjustment for potential confounders, having had a smoking parent during gestational development (OR 1.37, 95% CI 1.08-1.73, P = .009) and residing with a smoker during childhood (OR 1.40, 95% CI 1.10-1.79, P = .007) were each significantly associated with AF. Both positive associations were more pronounced among patients without risk factors for AF (P values for interaction <.05).

Conclusions: SHS exposure during gestational development and during childhood was associated with having AF later in life. This association was even stronger in the absence of established risk factors for AF. Our findings indicate that SHS in early life may be an important, potentially modifiable risk factor for the development of AF.

Keywords: Arrhythmia; Atrial fibrillation; Epidemiology; Lone atrial fibrillation; Prevention; Risk factors; Secondhand smoke.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollution, Indoor / adverse effects*
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / etiology
  • Child
  • Cross-Sectional Studies
  • Demography
  • Environmental Exposure / adverse effects
  • Environmental Exposure / prevention & control
  • Environmental Exposure / statistics & numerical data
  • Female
  • Global Health
  • Humans
  • Longitudinal Studies
  • Male
  • Pregnancy
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Prevalence
  • Risk Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Tobacco Smoke Pollution* / adverse effects
  • Tobacco Smoke Pollution* / prevention & control
  • Tobacco Smoke Pollution* / statistics & numerical data
  • Workplace*


  • Tobacco Smoke Pollution