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Lavallee P, Charles H, Labreuche J, Albers GW, Caplan L, Donnan GA, Ferro JM, Hennerici MG, Molina CA, Rothwell P, Steg G, Touboul PJ, Uchiyama S, Vicaut E, Wong LKS, Amarenco P. Assessment of smoking care by stroke specialists in patients with recent TIA and minor stroke: an international prospective registry-based cohort study. BMJ Open 2024; 14:e078632. [PMID: 38960468 PMCID: PMC11227765 DOI: 10.1136/bmjopen-2023-078632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVES The objectives are to assess smoking abstinence and its effects on vascular risk and to report tobacco-cessation counselling and pharmacotherapy use in patients who had a recent minor stroke or transient ischaemic attack (TIA). DESIGN AND SETTING The TIA registry.org project is a prospective, observational registry of patients with TIA and minor stroke that occurred in the previous 7 days with a 5-year follow-up, involving 61 sites with stroke specialists in 21 countries (Europe, Asia, Latin America and Middle East). Of those, 42 sites had 5-year follow-up data on more than 50% of their patients and were included in the present study. PARTICIPANTS From June 2009 through December 2011, 3847 patients were eligible for the study (80% of the initial cohort). OUTCOMES Tobacco counselling and smoking-cessation pharmacotherapy use in smoking patients were reported at discharge. Association between 3-month smoking status and risk of a major cardiovascular event (MACE) was analysed with multivariable Cox regression model. RESULTS Among 3801 patients included, 835 (22%) were smokers. At discharge, only 35.2% have been advised to quit and 12.5% had smoking-cessation pharmacotherapy prescription. At 3 months, 383/835 (46.9%) baseline smokers were continuers. Living alone and alcohol abuse were associated with persistent smoking; high level of education, aphasia and dyslipidaemia with quitting. The adjusted HRs for MACE at 5 years were 1.13 (95% CI 0.90 to 1.43) in former smokers, 1.31 (95% CI 0.93 to 1.84) in quitters and 1.31 (95% CI 0.94 to 1.83) in continuers. Using time-varying analysis, current smoking at the time of MACE non-significantly increased the risk of MACE (HR 1.31 (95% CI 0.97 to 1.78); p=0.080). CONCLUSION In the TIAregistry.org, smoking-cessation intervention was used in a minority of patients. Surprisingly, in this population in which, at 5 years, other vascular risk factors were well controlled and antithrombotic treatment maintained, smoking cessation non-significantly decreased the risk of MACE.
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Affiliation(s)
- Philippa Lavallee
- Neurology, Bichat-Claude-Bernard Hospital Neurology Service, Paris, France
| | - Hugo Charles
- Department of Neurology and Stroke Center, Hopital Bichat-Claude-Bernard Service de Neurologie, Paris, Île-de-France, France
- Universite Paris Cite, Paris, Île-de-France, France
| | | | - Gregory W Albers
- Department of Neurology and Neurogical Sciences, Stanford University, Stanford, California, USA
| | - Louis Caplan
- Harvard University, Cambridge, Massachusetts, USA
| | | | - José Manuel Ferro
- Department of Neurosciences (Neurology), University of Lisbon, Lisboa, Portugal
| | - M G Hennerici
- Department of Neurology, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Carlos A Molina
- Department of Neurology, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Peter Rothwell
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Gabriel Steg
- Hôpital Bichat-Claude-Bernard, Paris, Île-de-France, France
| | | | | | - Eric Vicaut
- Department of Biostatistics, Hôpital Fernand-Widal, Paris, Île-de-France, France
| | - Lawrence K S Wong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong
| | - Pierre Amarenco
- Department of Neurology and Stroke Center, Hopital Bichat-Claude-Bernard Service de Neurologie, Paris, Île-de-France, France
- Universite Paris Cite, Paris, Île-de-France, France
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Abeysekera I, De Silva R, Silva D, Piumika L, Jayathilaka R, Rajamanthri L. Examining the influence of global smoking prevalence on stroke mortality: insights from 27 countries across income strata. BMC Public Health 2024; 24:857. [PMID: 38504226 PMCID: PMC10953178 DOI: 10.1186/s12889-024-18250-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/01/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND This study investigates the influence of Global Smoking Prevalence (GSP) on Stroke Death Rates (SDR) across 27 countries categorized into High-Income Countries (HIC), Upper Middle-Income Countries (UMIC), Lower Middle-Income Countries (LMIC), and Low-Income Countries (LIC). METHODS Analysing data from two distinct periods (1990-1999 and 2010-2019), countries exhibiting an increased SDR were selected. The study uses a polynomial regression model, treating income groups as cross-sectional and years as time series data. RESULTS Results from the regression model reveal that 17 countries observed a significant impact of GSP on SDR, with only Turkey, Solomon Islands, and Timor-Leste resulting in negative values. However, the study emphasises that out of all 27 countries, the highest occurrence of the impact of GSP on SDR has been reported in the LMIC stratum for the period under review. CONCLUSION It is evident that GSP affects the risk of incidence of stroke death, specifically in the LMIC stratum. Furthermore, it has been identified that GSP is a major preventable risk factor affecting global mortality. To mitigate the risk of stroke death attributable to smoking prevalence, necessary preventive steps should be adopted to encourage smoking cessation, and essential policies should be implemented to reduce the burden of SDR.
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Affiliation(s)
- Isuri Abeysekera
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| | - Roshinie De Silva
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| | - Disuri Silva
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| | - Lakindu Piumika
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| | - Ruwan Jayathilaka
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka.
| | - Lochana Rajamanthri
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
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Hassan MA, Mohamed IA, Omar AA, Adan ZM, Garba B, Badawi OH. Sildenafil Use and Cigarette Smoking Associated with Intracerebral Hemorrhage: A Rare Case Report. Vasc Health Risk Manag 2024; 20:21-26. [PMID: 38222901 PMCID: PMC10787546 DOI: 10.2147/vhrm.s443995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024] Open
Abstract
Background Intracerebral hemorrhage (ICH) is a serious condition characterized by bleeding within the brain tissue. Although the use of sildenafil, a vasodilator agent for erectile dysfunction, has been associated with rare cases of ICH, the combination of sildenafil usage and smoking as risk factors for ICH has not yet been reported. This case report describes the occurrence of ICH in a patient with a history of both sildenafil usage and heavy smoking. Case Presentation A 53-year-old male, with a history of smoking and regular sildenafil use, was brought to the emergency department due to loss of consciousness with right-side weakness, he initially experienced with nausea, vomiting and dizziness after taking sildenafil 100mg tablet once. The Glasgow Coma Score (GCS) was 10 with side hemiparesis. Non-contrast CT revealed left thalamic acute hemorrhage with ventricular extension. Furthermore, a head CT angiography ruled out any vascular anomalies after that the patient was admitted to the intensive care unit (ICU) for conservative management. After three days on clinical and neurological improvement, the patient was transferred to the inpatient ward for further management, monitoring and physiotherapy. On day 6, the patient was discharged and planned for flow up. Conclusion This rare case highlights the need for further research and awareness regarding the potential risks associated with the combination of sildenafil and heavy smoking. Healthcare professionals should carefully evaluate the individual risk factors of patients, educate them about potential complications, and consider alternative treatments if necessary. Additionally, patients should be encouraged to quit smoking and adopt a healthy lifestyle to minimize the risk of cerebrovascular events.
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Affiliation(s)
- Mohamed Abdulahi Hassan
- Department of Internal Medicine and Intensive Care Unit, Dr. Sumait Hospitals Affiliated of SIMAD University, Mogadishu, Somalia
- Department of Medicine and Surgery of Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia
| | - Ibrahim Abdullahi Mohamed
- Department of Internal Medicine and Intensive Care Unit, Dr. Sumait Hospitals Affiliated of SIMAD University, Mogadishu, Somalia
| | - Abdullahi Abdirahman Omar
- Department of Internal Medicine and Intensive Care Unit, Dr. Sumait Hospitals Affiliated of SIMAD University, Mogadishu, Somalia
| | - Zakaria Mohamed Adan
- Department of Internal Medicine and Intensive Care Unit, Dr. Sumait Hospitals Affiliated of SIMAD University, Mogadishu, Somalia
| | - Bashiru Garba
- Department of Public Health, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia
| | - Omar Hassan Badawi
- Department of Radiology, Dr. Sumait Hospitals affiliated of SIMAD University, Mogadishu, Somalia
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Peng JW, Nfor ON, Ho CC, Hsu SY, Chou MC, Liaw YP. Independent and Interactive Effects of Sex and CYP2C9 Variant rs4918758 on Ischemic Stroke Risk in Taiwan Biobank. Int J Gen Med 2022; 15:3583-3589. [PMID: 35392030 PMCID: PMC8982806 DOI: 10.2147/ijgm.s351753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/11/2022] [Indexed: 01/26/2023] Open
Abstract
Purpose Stroke is a complex health condition caused by multiple risk factors. We investigated whether the Cytochrome P450 2C9 (CYP2C9) rs4918758 polymorphism and sex were independently and interactively associated with ischemic stroke risk among Taiwan Biobank (TWB) participants. Material and Methods We analyzed TWB data pertaining to 9197 female and 8625 male individuals. Data collected between 2008 and 2015 were linked to medical records in the National Health Insurance Database (NHIRD). Based on multiple logistic regression analyses, we estimated odds ratios (OR) and 95% confidence intervals (CI) for ischemic stroke. Results We found that 441 women and 468 men had ischemic stroke. There were no differences in the risk of ischemic stroke between individuals with the TC/CC genotype and those with the TT genotype [OR (95% CI) = 1.04 (0.90–1.21)]. When compared to women, men had an OR of 1.03 (95% CI = 0.87–1.22) for ischemic stroke. Based on further analysis, sex was found to interact with polymorphism rs4918758 (p for interaction = 0.0019). After categorizing by sex, men with TC/CC genotype showed significant ORs but not women [OR (95% CI) = 1.32 (1.07–16.33) vs 0.83 (0.68–1.00)]. Further stratification by genotype showed that in comparison with their female counterparts, men with the TT and TC/CC genotypes had ORs of 0.59 (95% CI = 0.44–0.80) and 1.36 (95% CI = 1.10–1.68), respectively. Conclusion According to our study, the TT genotype of rs4918758 was associated with a reduced risk of ischemic stroke in Taiwanese men when compared to women, whereas the TC/CC genotype was associated with a greater risk.
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Affiliation(s)
- Jui-Wen Peng
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Oswald Ndi Nfor
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Chien-Chang Ho
- Department of Physical Education, Fu-Jen Catholic University, New Taipei City, 24205, Taiwan
- Research and Development Center for Physical Education, Health, and Information Technology, Fu Jen Catholic University, New Taipei, 24205, Taiwan
| | - Shu-Yi Hsu
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Ming-Chih Chou
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- Ming-Chih Chou, No. 110 Sec. 1 Jianguo N. Road, Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan, Tel +886424730022 ext. 11191, Fax +886423248130, Email
| | - Yung-Po Liaw
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
- Correspondence: Yung-Po Liaw, No. 110 Sec. 1 Jianguo N. Road, Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan, Tel +886436097501, Fax +886423248179, Email
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Gall SL, Sanderson K, Smith KJ, Patton G, Dwyer T, Venn A. Bi-directional associations between healthy lifestyles and mood disorders in young adults: The Childhood Determinants of Adult Health Study. Psychol Med 2016; 46:2535-2548. [PMID: 27338017 DOI: 10.1017/s0033291716000738] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Healthy lifestyles prevent cardiovascular disease and are increasingly recognized in relation to mental health but longitudinal studies are limited. We examined bi-directional associations between mood disorders and healthy lifestyles in a cohort followed for 5 years. METHOD Participants were aged 26-36 years at baseline (2004-2006) and 31-41 years at follow-up (2009-2011). At follow-up, lifetime mood disorders (depression or dysthymia) were retrospectively diagnosed with the Composite International Diagnostic Interview. A five-item lifestyle score (comprising body mass index, non-smoking, alcohol consumption, leisure time physical activity and healthy diet) was measured at both time points. Linear and log multinomial regression determined if mood disorder before baseline predicted changes in lifestyle (n = 1041). Log binomial regression estimated whether lifestyle at baseline predicted new episodes of mood disorder (n = 1233). Covariates included age, sex, socio-economic position, parental and marital status, social support, major life events, cardiovascular disease history, and self-rated physical and mental health. RESULTS A history of mood disorder before baseline predicted unfavourable trajectories of lifestyle over follow-up, including somewhat lower risk of improvement [relative risk (RR) 0.76, 95% confidence interval (CI) 0.56-1.03] and greater risk of worsening (RR 1.46, 95% CI 0.99-2.15) of lifestyle independent of confounding factors. Higher lifestyle scores at baseline were associated with a 22% (RR 0.76, 95% CI 0.61-0.95) reduced risk of first episodes of mood disorder, independent of confounding factors. CONCLUSIONS Healthy lifestyles and mood disorders are closely related. Our results suggest that healthy lifestyles may not only reduce cardiovascular disease but also promote mental health.
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Affiliation(s)
- S L Gall
- University of Tasmania,Menzies Institute for Medical Research,Hobart,TAS,Australia
| | - K Sanderson
- University of Tasmania,Menzies Institute for Medical Research,Hobart,TAS,Australia
| | - K J Smith
- University of Tasmania,Menzies Institute for Medical Research,Hobart,TAS,Australia
| | - G Patton
- Murdoch Children's Research Institute,Centre for Adolescent Health,Parkville,VIC,Australia
| | - T Dwyer
- University of Tasmania,Menzies Institute for Medical Research,Hobart,TAS,Australia
| | - A Venn
- University of Tasmania,Menzies Institute for Medical Research,Hobart,TAS,Australia
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The Prognostic Effect of Cigarette Smoking on Stroke Severity, Disability, Length of Stay in Hospital, and Mortality in a Cohort with Cerebrovascular Disease. J Stroke Cerebrovasc Dis 2013; 22:e446-54. [DOI: 10.1016/j.jstrokecerebrovasdis.2013.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 04/24/2013] [Accepted: 05/01/2013] [Indexed: 11/22/2022] Open
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"Addressing the impact of stroke risk factors in a case control study in tertiary care hospitals": a case control study in Tertiary Care Hospitals of Peshawar, Khyber Phukhtoonkhwa (KPK) Pakistan. BMC Res Notes 2013; 6:268. [PMID: 24059905 PMCID: PMC3726395 DOI: 10.1186/1756-0500-6-268] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 07/04/2013] [Indexed: 12/17/2022] Open
Abstract
Background Stroke was the second most common cause of death worldwide in 2004, resulting in 5.7 million deaths. This case controlled study was conducted in Tertiary care hospitals of Peshawar, KPK Pakistan about common risk factors of stroke and the impact of these risk factors. Method Study was done at Government Tertiary Care Hospitals of Peshawar namely Khyber Teaching Hospital (KTH), Lady Reading Hospital (LRH) and Hayatabad Medical Complex (HMC).The hospital based case–control study included 50 cases (stroke patients) and 100 controls (non-stroke patients). This study was accomplished from 24th April 2012 to October 2012 in tertiary care hospitals of Peshawar. A proper questionnaire was used to collect data from all the cases and controls, which was recorded in the form of tables and graphs. The risk factors studied were Hypertension, Smoking, diabetes, sedentary lifestyle, cardiac problems, B.M.I, diet, stress and family history of stroke. Anthropometric (weight, height, body mass index) measurements were done on all patients. For determination of association and impact of these risk factors, analyses were performed by calculation of Chi-Square test and confidence interval using SPSS version 16 program. Results Comparing the cases with controls, hypertension (p = 0.000), sedentary life style (p = 0.000), cardiac problems (p = 0.009), diabetes mellitus (p = 0.010), smoking (p = 0. 042) were significant risk factors whereas B.M.I (p = 0. 393), stress (p = 0.705), family history of stroke (p = 0.729), diet (p = 0.908), were not found to be statistically significant risk factors. The most significant risk factor was systemic hypertension (OR = 4.16) followed by sedentary life style (OR = 3.60), cardiac problems (OR = 2.74) diabetes (OR = 2.49) and smoking (OR = 2.05). Conclusion Hypertension, Smoking, diabetes, sedentary lifestyle and cardiac problems have strong correlations and association with Stroke and are the major risk factors of stroke. Prevention of these risk factors can lead to decrease in the incidence of stroke. B.M.I, diet, stress and family history of stroke had no significant association.
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Quintana-Carrillo RH, Arauz A, San-Juan D, de Santiago ITL, Aguirre-Cruz L, Corona T, Reynales-Shigematsu LM. The Economic Impact of Smoking on the Treatment Costs of Stroke at a Tertiary Care Neurological Center in Mexico. Int J Stroke 2013; 8:E23. [DOI: 10.1111/ijs.12121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Roger Humberto Quintana-Carrillo
- Departamento de Investigación sobre Tabaco, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Antonio Arauz
- Clínica de ECV, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, México
| | - Daniel San-Juan
- Dirección de Investigación, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, México
| | | | - Lucinda Aguirre-Cruz
- Dirección de Investigación, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, México
| | - Teresa Corona
- Dirección General, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, México
| | - Luz Myriam Reynales-Shigematsu
- Departamento de Investigación sobre Tabaco, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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Guía para el tratamiento preventivo del ictus isquémico y AIT (I). Actuación sobre los factores de riesgo y estilo de vida. Neurologia 2012; 27:560-74. [DOI: 10.1016/j.nrl.2011.06.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 06/13/2011] [Accepted: 06/29/2011] [Indexed: 11/23/2022] Open
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Guidelines for the preventive treatment of ischaemic stroke and TIA (I). Update on risk factors and life style. NEUROLOGÍA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.nrleng.2011.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Manufactured and hand-rolled cigarettes and smokeless tobacco consumption in Mozambique: regional differences at early stages of the tobacco epidemic. Drug Alcohol Depend 2011; 119:e58-65. [PMID: 21708433 DOI: 10.1016/j.drugalcdep.2011.05.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Revised: 05/12/2011] [Accepted: 05/30/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND To describe the use of different types of tobacco (manufactured and hand-rolled cigarettes, and smokeless tobacco) in the adult Mozambican population, across regions. METHODS A representative sample of 12,902 Mozambicans aged 25-64 years was evaluated in a national household survey conducted in 2003 using a structured questionnaire. The patterns of tobacco consumption were described to highlight the sex-specific differences by age and between urban and rural settings, and between the north, where most of the country's tobacco production is concentrated, and the south of the country, where the wealthiest provinces, closer to the city capital, are located. RESULTS The prevalence of current tobacco consumption was 39.9% in men and 18.0% in women. Women consumed predominantly smokeless tobacco (prevalence: 10.1%), especially in the north. Hand-rolled and manufactured cigarettes were the most frequently consumed among men (prevalences: 18.7% and 17.2%, respectively). Additionally, hand-rolled cigarette consumption predominantly occurred in the northern provinces and rural settings, whereas manufactured cigarette consumption predominated in the south and urban areas. CONCLUSIONS The overall tobacco consumption was higher than expected for an African country with scarce economic resources, mostly due to traditional forms of consumption. The gender and regional specific patterns of consumption identified in Mozambique may contribute to the development of culturally adapted and locally grounded actions for tobacco control, and stress the need of locale-specific surveillance data and public health action in this field.
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Sienkiewicz-Jarosz H, Zatorski P, Witkowski G, Rogowski A, Scińska A, Ryglewicz D. [Predictors of smoking cessation after stroke]. Neurol Neurochir Pol 2010; 44:181-7. [PMID: 20496288 DOI: 10.1016/s0028-3843(14)60009-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cigarette smoking is a major modifiable risk factor for stroke. Smoking dose dependently increases the risk of stroke, especially in patients below 75 years of age. Although smoking cessation is considered as one of the most effective methods of secondary stroke prevention, little is known about nicotine dependence and predictors of smoking cessation after stroke. Identification of such predictors could facilitate the development of anti-smoking interventions in post-stroke patients. Results of previous studies showed that smoking cessation is determined by the interplay of multiple factors, including sociodemographic (gender, age, race, living conditions, employment), clinical (functional status), psychobiological (nicotine dependence, depressed mood) and environmental (smoking household members) factors. Limitations of most studies were relatively small sample sizes and lack of verification of smoking status with a biochemical marker (e.g. expired CO). The aim of this article is to summarize current knowledge about predictors of smoking cessation after stroke.
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Bullen C, Whittaker R, McRobbie H, Fagerström K. A Clinical Imperative: Assisting Patients Who Smoke to Reduce Their Risk of Cardiovascular Disease. ACTA ACUST UNITED AC 2007; 10:5-9. [PMID: 17396062 DOI: 10.1111/j.1520-037x.2007.06525.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The role of tobacco smoking as a cause of cardiovascular disease is now unequivocal and well-documented in literally hundreds of epidemiologic and biomedical studies over the past 50 years. Cessation of smoking, on the other hand, swiftly and profoundly reduces the risks of a cardiovascular event. Thus, smoking cessation should be seen as perhaps the most effective lifesaving intervention in the physician's armamentarium. Despite this widely available knowledge, and evidence that most smokers want to quit, relatively few physicians offer cessation support to their smoking patients, even those at high risk for a cardiovascular event. This article reviews the links between tobacco smoking and cardiovascular disease, argues for a greater role for physicians in assisting smokers to quit, and highlights the most effective interventions currently available.
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Affiliation(s)
- Chris Bullen
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand.
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