Joosup Kim, from the Monash Medical Center in Clayton, Australia, and colleagues examined the association between smoking and the risk of death or further vascular events (recurrent stroke and myocardial infarction) in 1,589 patients with stroke recruited from 1996 to 1999 in a defined geographical region.

Over a ten-year period, the researchers found that, compared with never smokers, current smokers at the time of stroke had a significantly higher risk of poorer outcomes (hazard ratio [HR], 1.30). Among patients who survived for at least 28 days, compared with never smokers, poorer outcomes were also significantly more likely among current smokers (HR, 1.42) and ex-smokers (HR, 1.18). The risk of recurrent events was also elevated for current smokers versus past smokers (HR, 1.23).

"Patients who smoked at the time of their stroke or had smoked before their stroke had greater risk of death or recurrent vascular events when compared with patients who were never smokers," Kim and colleagues conclude. "People with stroke who are younger, or male, or living in more disadvantaged areas are likely to be smokers and these groups should be targeted for smoking cessation for primary prevention of stroke."

Abstract
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