Low-Level Cigarette Smoking and Longitudinal Change in Serum Cholesterol Among Adolescents

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Abstract
The current study was conducted to determine if smokers and nonsmokers differ in serum concentrations of high-density lipoprotein cholesterol (HDL-C) before smoking initiation and if a decline in HDL-C levels could be detected among adolescents during the first two years of smoking. Changes in HDL-C levels and smoking were observed longitudinally in 1983, 1984, and 1985 among 691 seventh and eighth graders (age range, 12 to 14 years) from two German cities; 82% were nonsmokers at baseline. For these baseline nonsmokers, no differences in baseline HDL-C concentrations were found between those who became smokers and those who remained nonsmokers. In contrast, those who became light (one to 39 cigarettes per week) or moderate (≥40 cigarettes per week) smokers by one or two years after the initial examination evidenced lower mean HDL-C concentrations relative to persistent nonsmokers at follow-up, constituting a decrement of −0.016 mmol/L [SE=.035] (−0.6 mg/dL) [SE=1.4] for light smokers and −0.114 mmol/L [SE=.064] (−4.4 mg/dL) [SE=2.5] for moderate smokers. These findings suggest that short-term exposure to cigarette smoke at low levels may have atherogenic consequences. (JAMA1988;259:2857-2862)