Smoking After Stroke Triples Risk of Death Within Year: Study

People who don't kick their smoking habit after having a stroke have a threefold increased risk of death within a year, a new study warns.

The investigators also found that the sooner stroke survivors start smoking again, the greater their risk of death within one year.

In the study, Italian researchers looked at 921 patients who were regular smokers before they suffered an ischemic stroke, which is caused by a lack of blood flow to the brain. All of the patients attended smoking-cessation counseling sessions while in the hospital and said they were motivated to remain smoke-free once they left the hospital.

No nicotine replacement therapy or other smoking cessation help was provided to the patients after they were discharged from the hospital.

The patients reported their smoking status at one, six and 12 months after leaving the hospital. By the end of the first year, 53 percent of them had resumed smoking. Older patients and women were most likely to begin smoking again, the study found.

Within one year, 89 patients had died. That works out to a one-year probability of death of 9.6 percent. After adjusting for a number of other factors, the researchers concluded that patients who resumed smoking were three times more likely to die than those who didn't begin smoking again.

The study was presented Tuesday at the European Society of Cardiology annual meeting in Munich.

"It is well established that smoking increases the risk of having a stroke," study author Furio Colivicchi, from San Filippo Neri Hospital in Rome, said in a society news release. "Quitting smoking after an acute ischemic stroke may be more effective than any medication in reducing the risk of further adverse events. However, on the other hand, our study shows that stroke patients resuming active smoking after leaving the hospital can raise their risk of dying by as much as threefold."

The sooner patients started smoking again, the greater their risk of death within a year. For example, those who resumed smoking within 10 days of leaving the hospital were five times more likely to die within a year than those who didn't resume smoking.

"The results of this study suggest that health-care providers should take smoking cessation interventions more seriously, as recommended treatments are not making their way into practice," Colivicchi said. "A successful program to help stroke patients quit smoking should take a comprehensive long-term approach, including individual counseling, post-discharge support and pharmacological treatment."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

While the study uncovered an association between smoking in stroke patients and death within one year, it did not prove a cause and effect relationship.