Format

Send to

Choose Destination
Prev Med. 2019 Jul;124:17-22. doi: 10.1016/j.ypmed.2019.04.022. Epub 2019 May 2.

Early smoking-onset age and risk of cardiovascular disease and mortality.

Author information

1
School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; School of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
2
School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Angiology and Vascular Surgery, Hospital del Mar, Barcelona, Spain; Cardiovascular Epidemiology and Genetics Group, REGICOR, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Center for the Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Barcelona, Spain.
3
Cardiovascular Epidemiology and Genetics Group, REGICOR, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Center for the Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Barcelona, Spain.
4
Cardiovascular Epidemiology and Genetics Group, REGICOR, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Center for the Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Barcelona, Spain; Department of Medicine, Faculty of Medicine, Universitat de Vic-Central de Catalunya, Vic, Spain.
5
Unitat de Suport a la Recerca de Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain; ISV Research Group, Research Unit in Primary Care, Primary Care Services, Girona Institut Català de la Salut (ICS), Catalonia, Spain; Biomedical Research Institute, Girona (IdIBGi), ICS, Spain.
6
Unitat de Suport a la Recerca de Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain; ISV Research Group, Research Unit in Primary Care, Primary Care Services, Girona Institut Català de la Salut (ICS), Catalonia, Spain; Biomedical Research Institute, Girona (IdIBGi), ICS, Spain; Department of Medical Sciences, School of Medicine, University of Girona, Spain.
7
Cardiovascular Epidemiology and Genetics Group, REGICOR, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Center for the Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Barcelona, Spain; Department of Medicine, Faculty of Medicine, Universitat de Vic-Central de Catalunya, Vic, Spain. Electronic address: relosua@imim.es.

Abstract

Early smoking onset age (SOA) is a public health concern with scant empirical evidence of its role in health outcomes. The study had two aims: i) to assess whether an early SOA was associated with the risk of fatal and non-fatal CVD and all-cause and CVD mortality and ii) to explore the linear and non-linear association between SOA and the outcomes of interest. Data from 4499 current or former smokers, recruited from 1995 to 2005, aged 25 to 79 years, and with a median 7.02 years of follow-up, were obtained from the REGICOR population-based cohort. In the present analysis, performed in 2018, the independent variable was SOA and the dependent variables were CVD events, CVD mortality, and all-cause mortality. Penalized smoothing spline methods were used to assess the linear and non-linear association. During follow-up, 361 deaths and 210 CVD events were recorded. A significant non-linear component was identified in the association between SOA and CVD outcomes with a cut-off point at 12 years: In the group aged ≤12 years, each year of delay in SOA was inversely associated with CVD risk (HR = 0.71; 95%CI = 0.53-0.96) and CVD mortality (HR = 0.58; 95%CI = 0.37-0.90). No association was observed in the older SOA group. A linear association was observed between SOA and all-cause mortality, and each year of delay was associated with 4% lower risk of mortality (HR = 0.96; 95%CI = 0.93-0.98). The associations were adjusted for lifelong exposure to tobacco and cardiovascular risk factors. These results reinforce the value of preventing tobacco use among teenagers and adolescents.

KEYWORDS:

Cardiovascular diseases; Cardiovascular risk; Mortality; Smoking; Smoking onset age; Youth

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center