Smoking Cessation After Stroke: Education and its Effect on Behavior
Background and Purpose: Smoking is a strong independent environmental risk factor for stroke. We sought to prospectively examine the impact of the diagnosis of stroke on smoking behavior at three months. Design: Patients admitted to 17 hospitals in the Greater Cincinnati area with a confirmed diagnosis of stroke were interviewed in the acute period after their event. A standardized questionnaire was utilized to collect detailed smoking history. Risk factor reduction was discussed with the patient and/or family members and printed risk reduction information was provided. Patients or their proxies were then contacted at three months and current smoking status was recorded. Results: Of 365 stroke patients, 99 were current smokers at baseline. There were no differences between the smokers and the non-smokers based on gender, race, age, and education. At three months, 44% of the baseline smokers had quit smoking (p<0.001), and the overall amount of daily cigarette use had decreased (p<0.001). Factors independently associated with reduction of smoking were white race(OR=2.3, 95% CI 1.0–5.5) and male gender (OR= 2.2, 95% CI 1.0–5.2). Conclusions: After a stroke, patients are motivated to change smoking behavior, as has been found with other life threatening diagnoses. Longer follow-up is needed to see if this behavior continues.