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Cardiovascular Effects of Secondhand Smoke: Nearly as Large as Smoking
Abstract
Background— Secondhand smoke increases the risk of coronary heart disease by ≈30%. This effect is larger than one would expect on the basis of the risks associated with active smoking and the relative doses of tobacco smoke delivered to smokers and nonsmokers. Methods and Results— We conducted a literature review of the research describing the mechanistic effects of secondhand smoke on the cardiovascular system, emphasizing research published since 1995, and compared the effects of secondhand smoke with the effects of active smoking. Evidence is rapidly accumulating that the cardiovascular system—platelet and endothelial function, arterial stiffness, atherosclerosis, oxidative stress, inflammation, heart rate variability, energy metabolism, and increased infarct size—is exquisitely sensitive to the toxins in secondhand smoke. The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking. Conclusions— The effects of secondhand smoke are substantial and rapid, explaining the relatively large risks that have been reported in epidemiological studies.
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“Even in cross-sectional studies conducted in Japan, the proportion of PAD, as determined using the ABI, was shown to be 3.7 times higher in current smokers (4.2 times for those with ≥ 45 pack-years) and 3.7 times in ex-smokers.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [114]
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Inequities in Noncommunicable DiseasesPreprint
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Metadata
- Authors
- Barnoya, J., & Glantz, S. A.
- Affiliations
- From the Center for Tobacco Control Research and Education, Cardiovascular Research Institute, and Division of Cardiology, University of California, San Francisco.
- University of California, San Francisco (US)
- ORCID
- Glantz, Stanton A.
- Venue
- Circulation
- Published
- 2005-05-24
- Volume
- 111
- Issue
- 20
- Pages
- 2684-2698
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1979836769
- Cited by
- 939
- References
- 167
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 32 · 2023: 34 · 2022: 25 · 2021: 25 · 2020: 29 · 2019: 44 · 2018: 42 · 2017: 41 · 2016: 47 · 2015: 55 · 2014: 57 · 2013: 69 · 2012: 73
- FWCI
- 27.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- passive smoking, coronary artery disease, cardiovascular effects, platelet function, endothelial function, arterial stiffness, atherosclerosis, oxidative stress, inflammation, heart rate variability, energy metabolism, myocardial infarct size
- MeSH terms
- Cardiovascular Diseases, Endothelium, Vascular, Heart Rate, Humans, Mitochondria, Risk, Smoking, Tobacco Smoke Pollution, Vascular Resistance, Platelet Activation, Oxidative Stress
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