Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
Department of Epidemiology, School of Public Health, University of Alabama, Birmingham.
Ann Epidemiol. 2019 Apr;32:28-34.e1. doi: 10.1016/j.annepidem.2019.01.012. Epub 2019 Feb 5.
Adult secondhand tobacco smoke (SHS) exposure is related to stroke and coronary heart disease (CHD) risk, but long-term effects are less clear. We evaluated whether childhood SHS exposure affects subsequent stroke or CHD risk among adult black and white never-smokers followed for stroke and CHD.
In this prospective cohort study, inverse probability weights were calculated to correct for bias due to attrition and survey nonresponse. Cox proportional hazards models were used to assess hazard ratios and 95% confidence intervals for stroke or CHD, separately, by number of childhood household smokers.
Of 13,142 eligible participants, 6136 had childhood SHS exposure assessed. Baseline mean (SD) age was 63.5 (9.0), 65% were female, 30% black, 46% reported 0 childhood household smokers, 36% reported 1, and 18% reported 2+. In 60,649 person-years, 174 strokes were observed (2.9% of participants), and in 45,195 person-years, 114 CHD events were observed (2.1% of participants). The weighted and adjusted hazard ratios (95% confidence intervals) of stroke for 2+ versus 0 childhood household smokers was 1.66 (1.29-2.13) and was 1.15 (0.82-1.59) for CHD.
We observed a significant association between childhood SHS exposure and stroke, but not CHD, after age 45 years and adjusting for missing information.
成人二手烟（SHS）暴露与中风和冠心病（CHD）风险有关，但长期影响尚不清楚。我们评估了儿童时期 SHS 暴露是否会影响成年不吸烟的黑人和白人中风和 CHD 风险。
在这项前瞻性队列研究中，使用逆概率权重来校正由于失访和调查无应答导致的偏差。Cox 比例风险模型分别用于评估中风或 CHD 的风险比和 95%置信区间，按儿童家庭吸烟者数量进行评估。
在 13142 名合格参与者中，有 6136 名参与者评估了儿童时期的 SHS 暴露情况。基线平均（SD）年龄为 63.5（9.0）岁，65%为女性，30%为黑人，46%报告有 0 名儿童家庭吸烟者，36%报告有 1 名，18%报告有 2+名。在 60649 人年中，观察到 174 例中风（2.9%的参与者），在 45195 人年中，观察到 114 例 CHD 事件（2.1%的参与者）。2+与 0 名儿童家庭吸烟者相比，中风的加权和调整后的风险比（95%置信区间）为 1.66（1.29-2.13），CHD 的风险比为 1.15（0.82-1.59）。
我们观察到，在调整缺失信息后，45 岁以上儿童时期 SHS 暴露与中风之间存在显著关联，但与 CHD 无关。
