Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease

Christopher Bullen


Expert Rev Cardiovasc Ther. 2008;6(6):883-895. 

In This Article


Smoking is a risk factor for ischemic stroke, hemorrhagic stroke and subarachnoid hemorrhage in both men and women[36] and increases the risk of mortality from stroke, although the dose-related increase seen in women is not as pronounced as in men.[37] In the Nurses' Health Study, Colditz et al. evaluated more than 118,539 US women aged 30–55 years for 8 years (1976–1984) and found that current smokers had a significantly higher rate of stroke, both nonfatal and fatal, and the risk of stroke increased with the number of cigarettes smoked daily.[38] More recently, Kelly and colleagues investigated the relationship between smoking and stroke incidence and mortality in a cohort study involving almost 170,000 Chinese men and women aged 40 years and over, followed for an average of 8.3 years.[39] The RRs of stroke and stroke mortality associated with current smoking compared with ever smoking were 1.28 (95% CI: 1.19–1.37) and 1.13 (95% CI: 1.03–1.25) in men and 1.25 (95% CI: 1.13–1.37) and 1.19 (95% CI: 1.04–1.36) in women, respectively, and there appeared to be a dose–response relationship with the number of cigarettes smoked per day and with duration of smoking. Smoking also potentiates the effects of other stroke risk factors, such as oral contraceptive use.[40]


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