Key result
Stroke survivors were less likely to have quit smoking compared with cancer survivors (OR 0.72; 95% CI 0.67-0.79) after adjusting for demographics and smoking-related comorbidities.
Why the study?
Continued smoking after stroke increases the risk of recurrence and cardiovascular disease, but the epidemiology of smoking cessation in US stroke survivors compared to cancer survivors was not comprehensively understood.
Are stroke survivors less likely to quit smoking compared to cancer survivors?
Cross-Sectional (n=4,434,604)
Yes
Are stroke survivors less likely to quit smoking compared to cancer survivors?
Odds Ratio: 0.72 (95% CI 0.67–0.79)
Stroke survivors have a significantly lower smoking quit ratio compared to cancer survivors, highlighting a critical gap in secondary cardiovascular prevention.
May highlight gaps in post-stroke cessation support; leaves open whether targeted interventions improve quit rates.
BACKGROUND: Continued smoking after stroke is associated with a high risk of stroke recurrence and other cardiovascular disease. We sought to comprehensively understand the epidemiology of smoking cessation in stroke survivors in the United States. Furthermore, we compared smoking cessation in stroke and cancer survivors because cancer is another smoking-related condition in which smoking cessation is prioritized. METHODS: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, an annual, nationally representative health survey. Using pooled data from 2013 to 2019, we identified stroke and cancer survivors with a history of smoking. We used survey procedures to estimate frequencies and summarize quit ratios with attention to demographic and geographic (state-wise and rural-urban) factors for stroke survivors. The quit ratio is conventionally defined as the proportion of ever smokers who have quit. Then, we used multivariable logistic regression to compare quit ratios in stroke and cancer survivors while adjusting for demographics and smoking-related comorbidities. RESULTS: Among 4 434 604 Americans with a history of stroke and smoking, the median age was 68 years (interquartile range, 59-76), and 45.4% were women. The overall quit ratio was 60.8% (95% CI, 60.1%-61.6%). Quit ratios varied by age group, sex, race and ethnicity, and several geographic factors. There was marked geographic variation in quit ratios, ranging from 48.3% in Kentucky to 71.5% in California. Furthermore, compared with cancer survivors, stroke survivors were less likely to have quit smoking (odds ratio, 0.72 [95% CI, 0.67-0.79]) after accounting for differences in demographics and smoking-related comorbidities. CONCLUSIONS: There were considerable demographic and geographic disparities in smoking quit ratios in stroke survivors, who were less likely to have quit smoking than cancer survivors. A targeted initiative is needed to improve smoking cessation for stroke survivors.
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A 2021 study conducted a cross-sectional in History of stroke and smoking (n=4,434,604). Stroke survivorship vs. Cancer survivorship was evaluated on Smoking quit ratio (OR 0.72, 95% CI 0.67-0.79). Stroke survivors were less likely to have quit smoking compared with cancer survivors (OR 0.72; 95% CI 0.67-0.79) after adjusting for demographics and smoking-related comorbidities.
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