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Smoking & Stroke Risk

How does smoking affect my stroke risk?

Smoking affects your metabolism and the chemistry of your blood vessels in several ways, all of which put you at increased risk for stroke:

  1. The chemicals in cigarettes damage the walls of the arteries, resulting in a buildup of fatty plaque that can harden and narrow the arteries, restricting blood flow to your brain.
  2. Smoking irritates the lungs and blood vessels, causing irritation inside the body (an inflammatory response) that increases the number of white blood cells and other predictors of increased risk for heart attack, stroke, and sudden death.
  3. Smoking makes the blood more likely to clot. These clots can travel in your bloodstream until they finally become stuck in one of the blood vessels in your brain, cutting off blood flow and triggering a stroke.
  4. Smokers tend to have high levels of LDL (bad) cholesterol and triglycerides—two types of blood fat that increase your risk of heart disease and stroke. Smoking also lowers HDL (good) cholesterol. HDL cholesterol helps remove LDL (bad) cholesterol from the artery walls.

Is smoking more harmful to women than men?

While smoking appears to have a greater effect on heart disease risk in women compared to men, most studies find that the increased stroke risk due to smoking is similar in women and men.2

Of special concern to women is the combined effect of smoking and birth control pills on stroke. In one study conducted by the World Health Organization, women who smoked but did not take birth control pills had only 1.3 times the risk of stroke compared with nonsmoking women who did not take birth control pills. Women who smoked while using birth control pills had a risk 7 times higher.6

See our article on Birth Control Pills for more information on the stroke risks of hormonal contraception.

Is light smoking harmful?

The more cigarettes you smoke the higher your stroke risk, but even light smoking is harmful.7 As few as 1 to 4 cigarettes a day doubles the risk of having a heart attack or dying from heart disease.8 No studies have examined what effect smoking just a few cigarettes a day may have on stroke risk in the long term.

Will quitting smoking help prevent stroke?

Yes. The risk of stroke decreases steadily after quitting smoking. Within 1 year of quitting, the elevated risk associated with smoking is reduced by 50%; former smokers have the same stroke risk as nonsmokers 5 years after quitting.9

Will cutting back lower my stroke risk?

Your level of stroke risk depends on how many cigarettes you smoke each day and how long you have been smoking. If you are unable to quit, smoking fewer cigarettes each day is preferable to continuing to smoke more. Keep in mind, though, that smoking even a few cigarettes a day is enough to change the chemistry of your blood vessels. Some of the damage that smoking causes occurs the minute you light up—the blood thickens and the arteries stiffen. The most effective way to lower your stroke risk and eliminate your smoking-related stroke risk completely over time is to quit smoking.

The Surgeon General’s Report on the Health Consequences of Smoking notes that cigarettes with lower yields of tar and nicotine have not been shown to lower your risk of heart disease or stroke and should not be considered lower-risk alternatives to regular cigarettes.2

What are the other health risks of smoking?

In addition to increasing your risk of stroke and heart disease, smoking also increases your risk of cancer, particularly lung cancer. It is also the major cause of respiratory problems, including emphysema. If you smoke, you are also more likely to develop plaque buildup and clots in the blood vessels of the legs (peripheral artery disease), making it painful to walk. Women who smoke have a higher risk of osteoporosis (bone loss), and they may go through menopause at a younger age than nonsmokers. Smoking is also linked to difficulty getting pregnant and problems during pregnancy, such as having a premature baby.

Next: Secondhand Smoke

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