Recently, the American Heart Association (AHA) published “Guidelines for Primary Prevention of Cardiovascular Disease and Stroke” as an aid to healthcare professionals and their patients without established coronary artery disease or other atherosclerotic diseases.1 The statement was intended to complement the AHA/American College of Cardiology (ACC) “Guidelines for Preventing Heart Attack and Death in Patients with Atherosclerotic Cardiovascular Disease.”2 Both sets of recommendations emphasized multifactorial interventions, especially more intensive measures/goals to modify individual cardiovascular risk factors with diet, drugs, exercise, weight management, complete smoking cessation, and avoidance of secondhand smoke (SHS), or combinations thereof.