Cardiovascular Consequences of Childhood Secondhand Tobacco Smoke Exposure: Prevailing Evidence, Burden, and Racial and Socioeconomic Disparities: A Scientific Statement From the American Heart Association

In the US, 4 of 10 school-aged children and 1 of 3 adolescents are exposed to SHS; children of minority ethnic backgrounds and low-socioeconomic-status households are disproportionately affected (68% and 43%)

Childhood SHS exposure is detrimental to arterial function and structure, resulting in premature atherosclerosis and its CV consequences

Childhood SHS exposure is related to impaired cardiac autonomic function and changes in heart rate variability

Childhood SHS exposure is associated with clustering of cardiometabolic risk factors (obesity, dyslipidemia, insulin resistance)

Individualized interventions to reduce childhood SHS exposure are at least modestly effective, as are policy initiatives such as community smoking bans and increased taxation

A robust public health policy embracing zero tolerance of childhood SHS exposure is called for