Smoking - Page 3

Does secondhand smoke increase my stroke risk?

It is well known that secondhand smoke increases the risk of heart disease in women and men who do not smoke. Evidence is growing that secondhand smoke has a similar effect on stroke risk. Secondhand smoke includes:

• Sidestream smoke – the smoke that comes from the tip of a burning cigarette
• Mainstream smoke – the smoke that is inhaled and then exhaled by smokers

The risk of heart disease and stroke increase rapidly at low doses of tobacco smoke exposure. After 20 minutes of exposure to secondhand smoke, the blood of nonsmokers thickens, making it more likely to clot. Sidestream smoke has a stronger blood thickening effect than mainstream smoke. After 15 to 30 minutes of exposure, the arteries are stiffer. Some studies have found that exposure to secondhand smoke nearly doubles the risk of stroke—making it almost as dangerous as active smoking.¹⁰

Do smoke-free policies reduce the prevalence of stroke?

Smoke-free policies, such as a ban on smoking in the workplace, have helped reduce both smokers' and nonsmokers' exposure to tobacco smoke. Scientists can confirm this by measuring blood levels of cotinine, a breakdown product of nicotine (nicotine doesn't stay in the blood long enough to be recorded over time). There was a 75% reduction in blood levels of cotinine in nonsmokers from 1999 to 2002 compared with 1988 to 1991. It is still too early to tell if this will translate into a dramatic reduction in the risk of stroke.

Quitting Smoking

Quitting smoking is one of the most important things you can do for you health, cardiovascular and otherwise. However, quitting smoking may be harder for women than for men. Many women are concerned that they will gain weight if they quit smoking. While you may gain 6 to 12 pounds in the year you quit smoking, bear in mind that almost 60% of people who continue to smoke will gain weight too. The health risks of smoking far outweigh the risks of gaining some weight. Don't let the fear of gaining a few pounds stop you from quitting smoking and significantly improving your health.

Women also differ from men in how they respond emotionally and physically to smoking cigarettes. Smoking cigarettes improves a woman's mood, making it more difficult for her to quit. That is why it is not a good idea to quit smoking before your period, because you may mistake premenstrual symptoms such as anxiety and irritability as symptoms of smoking withdrawal. Furthermore, women's bodies process nicotine differently, suggesting that nicotine replacement treatment should be tailored differently for women.¹¹

Please see our section on Quitting Smoking for more information and for links to resources that can help you succeed.

References

1. Shinton R, Beevers G. Meta-analysis of relation between cigarette smoking and stroke. BMJ. Mar 25 1989;298(6676):789-794.
2. Centers for Disease Control and Prevention. The Health Consequences of Smoking: A Report of the Surgeon General: Centers for Disease Control and Prevention; 2004.
3. Thun MJ, Apicella LF, Henley SJ. Smoking vs other risk factors as the cause of smoking-attributable deaths: confounding in the courtroom. JAMA. Aug 9 2000;284(6):706-712.
4. Wolf PA, D'Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991;22:312-318.
5. Kurth T, Kase CS, Berger K, Gaziano JM, Cook NR, Buring JE. Smoking and risk of hemorrhagic stroke in women. Stroke. Dec 2003;34(12):2792-2795.
6. Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case-control study. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Lancet. Aug 24 1996;348(9026):498-505.
7. Shaten BJ, Kuller LH, Neaton JD. Association between baseline risk factors, cigarette smoking, and CHD mortality after 10.5 years. MRFIT Research Group. Prev Med. Sep 1991;20(5):655-659.
8. Willett WC, Green A, Stampfer MJ, et al. Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. N Engl J Med. Nov 19 1987;317(21):1303-1309.
9. Wolf PA, D'Agostino RB, Kannel WB, Bonita R, Belanger AJ. Cigarette smoking as a risk factor for stroke. The Framingham Study. JAMA. February 19, 1988 1988;259(7):1025-1029.
10. Bonita R, Duncan J, Truelsen T, Jackson RT, Beaglehole R. Passive smoking as well as active smoking increases the risk of acute stroke. Tob Control. Summer 1999;8(2):156-160.
11. Perkins KA. Smoking cessation in women. Special considerations. CNS Drugs. 2001;15(5):391-411.