Enhancing smoke-free behaviour: prevention of stroke

Cigarette smoking is firmly established as a risk factor for stroke. The parameters of this relationship have recently been explored, and more than 50% of deaths from cerebrovascular disease among men and women aged less than 65 years were attributable to smoking. Shinton and Beevers in a meta-analysis summarized the relation between cigarettes smoked and stroke using 32 separate case control and cohort studies. A dose-response relationship was seen between the number of cigarettes smoked and the risk of stroke, women having a slightly greater relative risk than men (RR 1.72 vs. 1.43). It is estimated that 51% of deaths from cerebrovascular disease among men and 55% among women aged less than 65 years were attributable to smoking. In recent years, tobacco consumption per capita and the percentage of adults in the population who smoke have declined. Although approximately 60%-70% of smokers indicate that they would like to quit, and up to 50% of them attempt to quit each year, most have a great deal of difficulty doing so. Physicians are well positioned to provide help with quitting, given that approximately 70% of smokers see their doctor each year. Even a few minutes devoted to smoking cessation can produce a substantial increase in the number of patients who quit. Key components in this approach are the three A's of smoking intervention: Ask about smoking and patient readiness to quit, Advise all smoking patients to quit and Assist patients to do so. Despite evidence that physicians are giving patients more advice about smoking cessation, further gains need to be made.(ABSTRACT TRUNCATED AT 250 WORDS)