Childhood/adolescent smoking and adult smoking and cessation: The international childhood cardiovascular cohort (i3c) consortium

Tian Hu, Seana L. Gall, Rachel Widome, Lydia A. Bazzano, Trudy L. Burns, Stephen R. Daniels, Terence Dwyer, Johanna Ikonen, Markus Juonala, Mika Kähönen, Ronald J. Prineas, Olli Raitakari, Alan R. Sinaiko, Julia Steinberger, Elaine M. Urbina, Alison Venn, Jorma Viikari, Jessica G. Woo, David R. Jacobs

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


BACKGROUND: Despite declining US adolescent smoking prevalence from 40% among 12th graders in 1995 to around 10% in 2018, adolescent smoking is still a significant problem. Using the International Childhood Cardiovascular Cohort (i3C) Consortium, which includes 7 international cohorts recruited in childhood and followed into adulthood, the present study was designed to confirm the important relation between adolescent smoking and daily adult smoking and present new data on adult smoking into the forties and comparison of smoking in the United States, Finland, and Australia. METHODS AND RESULTS: Childhood smoking experience during ages 6 to 19 in the 1970s and 1980s was classifiable in 6687 i3C participants who also provided smoking status in their twenties and forties through 2011–2018. Prevalence of daily smoking in their twenties was directly related to degree of smoking during adolescence and inversely related to the age at which that smoking experience occurred (P trend, <0.001). Similar patterns were observed for prediction of smoking during age forties. Among the 2465 smokers in their twenties, cessation by their forties was generally inverse to degree of smoking in ages 6 to 19 (P trend, <0.001). Prevalence of smoking during adolescence and adulthood was similar among US, Finnish, and Australian participants. CONCLUSIONS: These long-term follow-up data show that smoking intensity increased throughout adolescence. Prevalence of adult smoking and cessation by the forties were both correlated with levels of childhood smoking intensity. These data lend support to preventive strategies designed to reduce, delay, or eliminate any youth access to cigarettes.

Original languageEnglish (US)
Article numbere014381
JournalJournal of the American Heart Association
Issue number7
StatePublished - 2020

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health (NIH; Grant No.: R01 HL121230). Harmonization and other data work before obtaining NIH funding were supported by the Australian National Health and Medical Research Council Project (Grant Nos.: APP1098369, APP211316), the Academy of Finland (Grant No.: 126925, 121584, 124282, 129378, 117787, and 41071), the Social Insurance Institution of Finland; Kuopio, Tampere, and Turku University Hospital Medical Funds, Juho Vainio Foundation, Paavo Nurmi Foundation, Finnish Foundation of Cardiovascular Research, Finnish Cultural Foundation, Sigrid Juselius Foundation, and Yrjö Jahnsson Foundation. Seana Gall is funded by the National Heart Foundation of Australia (FLF 100446 and 102061).

Publisher Copyright:
© 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.


  • Adult smoking
  • Childhood smoking intensity
  • Public policy
  • Smoking
  • Smoking cessation


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