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Childhood Secondhand Smoke Exposure and Risk of Dementia, Alzheimer’s Disease and Stroke in Adulthood: A Prospective Cohort Study

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Abstract

Background

This study aimed to investigate the associations between secondhand smoke exposure and dementia, Alzheimer’s disease (AD) and stroke.

Methods

This prospective study analyzed Framingham Offspring (FHS-OS) cohort participants with parents in the original Framingham Heart Study (FHS) cohort with known smoking status during offspring childhood. Surveillance for incident events, including dementia and stroke, among offspring participants exposed to parental smoking up to the age of 18 years commenced at examination 9 through 2014 and continued for approximately 30 years.

Results

At baseline, a total of 1683 (56.2%) subjects were not exposed to any secondhand smoke, whereas 670 (22.4%) subjects were exposed to 0–1 packs (20 cigarettes)/day, and 640 (21.4%) were exposed to over 1 pack/day. On follow-up (median: 31 years), 2993 patients developed dementia, including 103 with AD dementia and 315 with stroke. After adjusting for a wide range of established risk factors, participants with the highest exposure to secondhand smoke exhibited increased risks of all dementia, AD dementia and stroke compared with individuals with no exposure [HR 2.86 (2.00–4.09) for dementia; HR 3.13 (1.80–5.42) for AD dementia; HR 1.89 (1.37–2.61) for stroke]. The results remained comparable in the subgroup for individuals with median exposure to secondhand smoke.

Conclusion

Exposure to secondhand smoke may be associated with increased risks of dementia, AD dementia and stroke.

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Data Availability: Data described in the manuscript, code book, and analytic code will not be made available because the authors are prohibited from distributing or transferring the data and codebooks on which their research was based to any other individual or entity under the terms of an approved NHLBI Framingham Heart Study Research Proposal and Data and Materials Distribution Agreement through which the authors obtained these data.

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Acknowledgments

The authors thank the National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, and the Second People’s Hospital of Yibin/West China Yibin Hospital, Yibin, Sichuan.

Author information

Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, the Second People’s Hospital of Yibin/West China Yibin Hospital, Sichuan University, Yibin, Sichuan, China

    S. Zhou

  2. Department of Neurosurgery, Harvard Medical School and Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Kanran Wang

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  1. S. Zhou
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Contributions

Author Contributions: All authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: All authors. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: SF Zhou. Critical revision of the manuscript for important intellectual content: KR Wang. Statistical analysis: KR Wang. Obtained funding: KR Wang. Supervision: KR Wang. Grant Support: None. All authors have read the journal’s authorship agreement, and the manuscript has been reviewed by and approved by all named authors.

Corresponding author

Correspondence to Kanran Wang.

Ethics declarations

Ethical Standards: The study procedures followed were in accordance with the ethical standards of the Institutional Review Board and the Principles of the Declaration of Helsinki.

Conflicts of Interest: The authors declare that they have no conflicts of interest.

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Zhou, S., Wang, K. Childhood Secondhand Smoke Exposure and Risk of Dementia, Alzheimer’s Disease and Stroke in Adulthood: A Prospective Cohort Study. J Prev Alzheimers Dis 8, 345–350 (2021). https://doi.org/10.14283/jpad.2021.10

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  • DOI: https://doi.org/10.14283/jpad.2021.10

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