The Development of Cardiovascular Diseases in Children from Passive Smoking

Background: Passive smoking (PS) is associated with increase in the prevalence of cardiovascular diseases, and by at least 20% in the risk of death. Recent methodologically robust data from adult studies have shown that PS compromises health not only when non-smoking adults are exposed to PS frequently and for prolonged periods of time, as initially thought, but also after a single brief exposure. Aim: Review of the relationship between PS and the development of cardiovascular disease in children. Method: Literature review via search of the electronic databases Medline, Cochrane, EMBASE and CINAHL, using the key-words: “Passive smoking”, “children”, “cardiovascular disease” and selection from books, articles and studies from libraries. Results: Children exposed to PS at home are more likely to be overweight and obese, particularly when exposed during the first three years of their life. A consistent finding in most studies on childhood PS is its association with deterioration of the blood lipid profile, particularly lower levels of high-density lipoprotein (LDL), but also higher levels of total cholesterol, triglycerides and HDL cholesterol. PS appears to directly affect endothelial function in children, with increased destruction of the endothelium, via a dose-dependent decrease in the bioavailability of nitric oxide (NO). Conclusions: PS in children is linked with deterioration in vascular function and changes in the lipid profile which predispose to cardiovascular disease. The evidence for the effects of maternal smoking during pregnancy, and PS after birth is inconclusive, mainly due to limitations in the design of the relevant studies.