Smoking after stroke linked to earlier death

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As if there weren t already enough, a new study provides even further evidence of the extensive adverse health effects of smoking. According to a team of Italian researchers, people who continue to smoke after having a stroke have triple the risk of dying within a year.

The study, presented at the European Society of Cardiology in Munich, followed 921 smokers who suffered an ischemic stroke. While hospitalized, all of the patients received cessation counseling sessions and said they were motivated to give up the habit. However, upon discharge, no nicotine replacement therapy or other smoking cessation support was provided. During the one-year follow up, researchers found that 53 percent of the patients had resumed smoking, and those who did were three times more likely to die, compared to their non-smoking counterparts.

Furthermore, the sooner patients began smoking again, the greater their risk of death within a year. For example, patients who picked up the habit again within 10 days of leaving the hospital were five times more likely to die within a year than were those who managed to abstain from cigarettes.

Unfortunately, this study demonstrates the terrible addictiveness of smoking, says ACSH s Dr. Elizabeth Whelan. It s hard to fathom how, after an event as serious as a stroke, one could return to smoking. If anything, this should be a wake-up call to doctors and public health officials to promote alternative smoking cessation methods, including tobacco harm reduction.

Though smoking is a known risk factor for stroke, Dr. Bloom isn t completely sold on this study s findings. This research doesn t prove cause and effect, he notes. The extent to which these patients smoked prior to their stroke is an important factor to take into consideration. For instance, it's quite likely that the people who died were the heaviest smokers and in poorer health to begin with, thus they were more likely to start smoking again after a stroke. In which case, their previous habits could have a lot to do with their earlier deaths.