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A recent study has highlighted the significant risks of smoking from a young age, showing that children who begin smoking tobacco at age 10 or during their teenage years are likely to continue smoking into their mid-twenties. This continuous smoking habit substantially increases the risk of premature heart damage, according to the study conducted by researchers from the Universities of Bristol and Exeter in the UK, and the University of Eastern Finland. The findings were published in the Journal of the American College of Cardiology (JACC).
The study followed 1,931 children from the University of Bristol’s Children of the 90s cohort from age 10 to 24 years. At the study’s onset, only 0.3% of the children smoked cigarettes at age 10, but this figure rose significantly to 26% by their mid-twenties. Nearly two-thirds of those who started smoking in childhood or adolescence continued the habit into young adulthood.
The research found that active smoking from age 10 to 24 was associated with a 52% increased risk of premature heart damage by age 24, including an excessively enlarged heart, decreased heart relaxation, and increased blood flow pressure to the heart. Even after accounting for other risk factors such as high blood pressure, obesity, inflammation, dyslipidemia, and sedentary behavior, tobacco smoking alone contributed to a 30% increase in heart size during growth from ages 17 to 24.
While previous studies among adults have shown that adolescent smoking increases the risk of cardiovascular death by the mid-fifties, this study is the first to examine the earliest manifestations of long-term active smoking from childhood on heart health. The comprehensive study is the largest and longest follow-up of active tobacco smoking and repeated echocardiography assessments of heart structure and function in a large population of healthy youth.
Participants provided questionnaires on tobacco smoking at ages 10, 13, 15, 17, and 24, and underwent echocardiography measurements at ages 17 and 24. Their fasting blood samples were repeatedly tested for various biomarkers, and other factors such as blood pressure, heart rate, socio-economic status, and physical activity were also considered.
“Adolescence is a critical period for initiating smoking. The recent upsurge in vaping among teenagers is also a serious health concern, as vaping and e-cigarette products contain substances that can damage the lungs and cause abnormal heart rhythms,” said Dr. Andrew Agbaje, an award-winning physician and associate professor of Clinical Epidemiology and Child Health at the University of Eastern Finland. He added that the study’s findings could be extrapolated to vaping and e-cigarette users, who may be at risk of significant and irreversible heart damage.
“This study shows that teen smoking doesn’t just increase the risk of heart disease later in life—it causes early and lasting damage to heart muscle and function,” said Dr. Emily Bucholz, Assistant Professor of Pediatrics at the University of Colorado School of Medicine and Associate Editor of JACC. “It’s a wake-up call for prevention efforts to protect young hearts early.”
Dr. Agbaje concluded with a call to action: “Parents and caregivers must lead by example, and government agencies should be bold in addressing the preventable heart disease risk by creating a smoke and nicotine-free country. Raising tobacco taxes is insufficient, as the cost of healthcare due to smoking-related diseases far exceeds tobacco tax profits. We must say NO to tobacco and its fancy products to save the lives and future health of our children and adolescents.”
For more information, see the original study: Incidental and Progressive Tobacco Smoking in Childhood and Subsequent Risk of Premature Cardiac Damage, Journal of the American College of Cardiology (2024). DOI: 10.1016/j.jacc.2024.09.1229.
