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- Title
Early-life tobacco smoke exposure and stroke risk: a prospective study of 341,783 and 352,737 UK Biobank participants.
- Authors
Lin, Fabin; Chen, Xuanjie; Shi, Yisen; Yang, Kaitai; Hu, Guoping; Zhuang, Weijiang; Lin, Yifei; Huang, Tingting; Ye, Qinyong; Cai, Guoen; Wu, Xilin
- Abstract
Introduction: Stroke is a life-threatening condition that causes a major medical burden globally. The currently used methods for the prevention or prediction of stroke have certain limitations. Exposure to tobacco in early life, including smoking during adolescence and maternal smoking during pregnancy, can affect adolescent development and lead to several negative outcomes. However, the association between early-life tobacco exposure and stroke is not known. Methods: In this prospective cohort study, for the analyses involving exposure to maternal smoking during pregnancy and age of smoking initiation, we included 304,984 and 342,893 participants, respectively., respectively from the UK Biobank. Cox proportional hazard regression model and subgroup analyses were performed to investigate the association between early-life tobacco exposure and stroke. Mediation analyses were performed to identify the mediating role of biological aging in the association between early tobacco exposure and stroke. Results: Compared with participants whose mothers did not smoke during pregnancy, participants whose mothers smoked during pregnancy showed an 11% increased risk of stroke (HR: 1.11, 95% CI: 1.05–1.18, P < 0.001). Compared with participants who never smoked, participants who smoked during adulthood, adolescence and childhood showed a 22%, 24%, and 38% increased risk of stroke during their adulthood, respectively. Mediation analysis indicated that early-life tobacco exposure can cause stroke by increasing biological aging. Conclusion: This study reveals that exposure to tobacco during early life is associated with an increased risk of experiencing a stroke, and increased biological aging can be the underlying mechanism. Highlights: The first study to investigate the association between early-life tobacco exposure and stroke in a large-scale cohort database. The significant association between early-life tobacco exposure and the occurrence of stroke has been observed. Accelerated biological aging acts as a mediator in the association between early-life tobacco exposure and stroke.
- Subjects
UNITED Kingdom; TOBACCO smoke; SMOKING; PROPORTIONAL hazards models; LONGITUDINAL method
- Publication
BMC Public Health, 2024, Vol 24, Issue 1, p1
- ISSN
1471-2458
- Publication type
Article
- DOI
10.1186/s12889-024-18588-6