Early-Life Tobacco Exposure Increases Risk of Idiopathic Pulmonary Fibrosis: Study

A recent study revealed that early-life exposure to tobacco significantly elevates the risk of developing idiopathic pulmonary fibrosis (IPF) which is often a fatal lung disease. This study published in the Annals of the American Thoracic Society highlighted how genetic susceptibility and accelerated biological aging influence this increased risk.

This prospective cohort study examined the effects of maternal smoking around birth and the age at which individuals began smoking. The results revealed that maternal smoking around the time of birth increased the risk of developing IPF by 26% (Hazard Ratio [HR]: 1.26, 95% Confidence Interval [CI]: 1.11-1.43).

The risk of IPF was dramatically higher for individuals who started smoking during childhood (HR: 3.65, 95% CI: 3.02-4.41) when compared to those who never smoked. Adolescents (HR: 2.64, 95% CI: 2.28-3.05) and adults (HR: 2.09, 95% CI: 1.79-2.44) who took up smoking also expressed increased risk levels.

Also, one more finding was the additive interaction between genetic susceptibility and early-life tobacco exposure. Those with high genetic risk, maternal smoking exposure, and childhood smoking initiation had an astounding 16-fold greater risk of developing IPF (HR: 16.47, 95% CI: 9.57-28.32) when compared to individuals with low genetic risk and no tobacco exposure.

The study explored how accelerated biological aging, measured by telomere length and phenotypic age, mediated the effects of early-life tobacco exposure on IPF risk. Approximately 10% of the increased risk associated with maternal smoking was explained by these aging markers. This mediation effect was weaker for individuals who began smoking at later stages of life.

Overall, these findings illuminate the importance of protecting children and adolescents from tobacco exposure. The data from this study clearly show that maternal smoking and early smoking initiation create a dangerous combination for lung health, particularly when genetic vulnerability is present.

The results of this study call for stronger public health initiatives to reduce prenatal tobacco exposure and prevent youth from starting to smoke. In addition, it underscores the importance of genetic screening and monitoring biological aging markers for individuals at high risk of developing IPF.

Source:

Zhu, J., Wang, Y., Liu, H., Wang, M., Wang, J., Ding, L., Zhou, D., & Li, Y. (2025). Early-life exposure to tobacco smoke and the risk of idiopathic pulmonary fibrosis: A population-based cohort study. Annals of the American Thoracic Society. https://doi.org/10.1513/annalsats.202409-906oc