November 6, 2011

Smoking Cessation Easier After Stroke

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Joseph V. Madia, MD By:

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Following a stroke brain damage and intention can influence smoking cessation success

(dailyRx News) After a stroke some patients may find it easier to quit smoking. There may be a good reason for that. Smokers who intended to stop prior to the stroke and those who have a particular area of their brain damaged by stroke are more likely to quit.

Giving up the habit isn't easy, but some stroke patients seem to be having better success.

Rosa Suñer, lead author of the study, researcher at the Josep Trueta Hospital and a professor of nursing at Girona University in Spain, said she found both biological and psychological factors may influence a patient's smoking status after a stroke.

"If you smoke, ask your doctor about smoking cessation programs."

Surprisingly, during the study, investigators also found that only a third of patients knew that smoking was a risk factor for stroke. Another third were not sure and a third thought it was not a risk factor.

Researchers evaluated smoking history and medical information including type and location of stroke, functional state of the patient at discharge and hospital stay length for 110 stroke patients who smoked. Prior to their strokes, the patients smoked an average of 28 cigarettes a day and had been smoking since age 17.

They were followed up to a year after hospital discharge. When discharged from the hospital, 76 of the patients had quit smoking, but only 44 remained smoke-free a year later.

Investigators found that stroke patients who had planned to quit smoking before having a stroke were more than twice as likely to have success in quitting smoking.

They also discovered that patients who experienced damage to the brain's insular cortex, which is involved in processing emotions, were more than twice as likely to be a non-smoker a year later as compared to patients with other brain injuries.

Suñer noted that public knowledge about the association between smoking and stroke is not as strong as with other diseases. She said the study findings could aid in tailoring individual treatment and education programs for smokers following a stroke.

"Adding additional awareness of yet another down side to the habit seems to me to have little hope of altering behavior. However, in this study it appears that structural brain damage was the most potent predictor of future abstinence from the habit. This says something profound about the strength of the addiction," said Dr. Frank Meissner, an invasive cardiologist and clinical assistant professor of medicine at the Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center.

"What I have personally found is the most effective strategy to facilitate smoking cessation is taking time out of my own office visits with patient's to emphasize the importance of smoking cessation with respect to positive health outcomes. To do this personally as the physician caring for the patient is much more effective, again in my personal experience, than smoking cessation programs, counseling sessions, nicotine patches, or abstinence pharmacotherapy."

The clinical study was recently published in Stroke: Journal of the American Heart Association.

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Reviewed by: 
Joseph V. Madia, MD
Review Date: 
November 3, 2011

Last Updated:
November 6, 2011