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Utilizing a defined general population, two investigations were conducted in Washington County, Maryland. In the eight-year mortality study, the relative risk of stroke among cigarette smokers was only 0.85 as compared to nonsmokers. In the two-year morbidity investigation, limited to stroke cases occurring after the age of 50, it appears that the association of cigarette smoking to strokes in the older age groups is at most very small. In atherosclerotic strokes, there may be an association with cigarette smoking, but only in the younger age groups, as suggested by two other studies. In order to investigate this possibility a retrospective case/control study of young cases is recommended. If there is no age dependency of atherosclerotic strokes, this implies that cigarette smoking may not be associated with the atherosclerotic process in cerebral and coronary arteries.
Nomura et al. (1974) studied this question.