Disclosures: Parikh reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
November 24, 2021
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Stroke survivors less likely to quit smoking than cancer survivors

Disclosures: Parikh reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Compared with cancer survivors, stroke survivors were less likely to quit smoking, with nearly 40% continuing to smoke after the stroke, suggested new data.

Neal S. Parikh

“These data support the need for interventions to address the substantial proportion of stroke survivors with a smoking history who continues to smoke,” Neal S. Parikh, MD, MS, assistant professor of neurology and neuroscience at Weill Cornell Medicine, and colleagues wrote.

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Parikh said in a press release that the Moonshot initiative of the National Cancer Institute (NCI), which includes smoking cessation among people with cancer, served as the impetus for the study. “We were curious to understand smoking among people with stroke and cardiovascular disease,” Parikh said. “In part to assess whether a similar program is necessary for stroke survivors, our team compared smoking cessation rates between stroke survivors and cancer survivors.”

Parikh and colleagues performed a cross-sectional data analysis using the CDC Behavioral Risk Factor Surveillance System, an annual, nationally representative health survey. They used pooled data from 2013 to 2019 to locate stroke and cancer survivors with a history of smoking, and employed survey procedures to estimate frequencies and summarize quit ratios with attention to demographic and geographic factors for stroke survivors.

The proportion of ever smokers who have quit served as the conventional definition for the quit ratio.

The study included 4,434,604 Americans with a history of stroke and smoking (median age, 68 years; 45% women).

Data indicated that the overall quit ratio for stroke survivors was 60.8% (95% CI, 60.1-61.6), with quit ratios varying by age group, sex, race and ethnicity, and several geographic factors. With the latter finding, researchers observed a marked geographic variation in quit ratios, ranging from 48.3% in Kentucky to 71.5% in California.

After adjusting for demographics and smoking-related comorbidities, stroke survivors were at decreased odds for having quit smoking compared with cancer survivors (OR = 0.72; 95% CI, 0.67-0.79).

Going forward, Parikh said important next steps will include devising and testing optimal smoking cessation programs for people who have had a stroke or transient ischemic attack.

“Programs for patients with stroke and cardiovascular disease should be as robust as smoking cessation programs offered to patients with cancer,” Parikh said in the release. “At NCI-designated sites, smoking cessation programs often include a dedicated, intensive counseling program, a trained tobacco cessation specialist, and health care professionals with specific knowledge about the use of smoking cessation medications. Hospital systems could also adjust care protocols so that every stroke patient receives a consultation with a tobacco cessation specialist and is enrolled in a smoking cessation program with the option to opt out, as opposed to having to seek out a program.”

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