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(Circulation. 2007;115:3143-3144.)
© 2007 American Heart Association, Inc.

Editorial

Protecting Children From Passive Smoking

David S. Celermajer, DSc

From the Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, and University of Sydney, Sydney, Australia.

Correspondence to David S. Celermajer, DSc, Department of Cardiology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown 2050 Australia. E-mail david.celermajer@email.cs.nsw.gov.au

Key Words: Editorials • atherosclerosis • endothelium • smoking

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Where once my careless childhood strayed

A stranger yet to pain...

No sense have they of ills to come

Nor care beyond today.

— —Thomas Gray, "Ode on a Distant Prospect of Eton College," 1768

Childhood is a time in which foundations are laid on which the adult is formed. Nevertheless, it is surprising for most to discover just how early in life arteries can show signs of structural or functional damage that may indicate vulnerability to atherosclerosis. Napoli et al¹ were the first to demonstrate that even fetal aortas could develop fatty streaks in utero in the presence of maternal hyperlipidemia, and recently, Skilton et al² have documented in vivo evidence of aortic wall thickening in at-risk newborns because of intrauterine growth restriction. Evidence of functional arterial abnormalities also has been documented in the first decade of life in high-risk children (eg, in those with familial hypercholesterolemia).³ Although such abnormalities do not usually lead to clinical consequences until middle adulthood, their genesis in childhood underscores the 2 key missions of atheroprevention: early detection of individuals and groups at risk and definition of strategies to prevent or reverse early atherogenic changes.

Article p 3205

Cigarette smoke remains one of the most prevalent modifiable risk factor for atherosclerosis. Whereas early epidemiological and mechanistic studies focused on active smoking and its effects on cardiovascular events, key research in the 1990s indicated that exposure to environmental tobacco smoke (ETS) also had significant adverse consequences for arterial health. Nonsmoking adults exposed to ETS have . . . [Full Text of this Article]