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Meta-analysis of relation between cigarette smoking and stroke
BMJ (Clinical Research Ed.)
|March 25, 1989
Summary
Cigarette smoking significantly increases stroke risk, with a 1.5 overall relative risk. This meta-analysis confirms smoking as a major cause of stroke, impacting various stroke subtypes differently.
Area of Science:
- Epidemiology
- Public Health
Background:
- Inconsistent findings exist regarding the link between cigarette smoking and stroke risk.
- A comprehensive meta-analysis is needed to clarify this association.
Purpose of the Study:
- To conduct a meta-analysis to determine the overall and subtype-specific risks of stroke associated with cigarette smoking.
- To investigate the influence of age, smoking dose, sex, and smoking cessation on stroke risk.
Main Methods:
- A systematic search was performed to identify all published studies on smoking and stroke.
- Relative risks (RR) from individual studies were pooled using precision weighting for the meta-analysis.
- Thirty-two studies were analyzed to calculate overall and stratified risks.
Main Results:
- The overall relative risk of stroke for cigarette smokers was 1.5 (95% CI: 1.4–1.6).
- Subtype risks varied: cerebral infarction (RR=1.9), cerebral hemorrhage (RR=0.7), and subarachnoid hemorrhage (RR=2.9).
- Risk increased with smoking dose and was higher in younger age groups; ex-smokers retained an elevated risk (RR=1.2).
Conclusions:
- Cigarette smoking presents a significant excess risk of stroke.
- Stroke should be recognized as a smoking-related disease.
- Public health initiatives should emphasize smoking cessation to mitigate stroke incidence.