Stroke Risk for Black Smokers Double That of Nonsmokers: Report

A new study in the Journal of the American Heart Association suggests that the risk for stroke doubles in blacks who smoke cigarettes compared with nonsmokers.

“Blacks are disproportionately affected by stroke compared with whites; however, less is known about the relationship between stroke and cigarette smoking in blacks,” the authors wrote. “Therefore, we evaluated the relationship between cigarette smoking and all incident stroke in the Jackson Heart Study.

The researchers included 5,306 study participants between the ages of 21 and 84 without a history of stroke. Participants were self-classified at baseline by smoking status (classifications include current, [past, defined as having smoked at least 400 cigarettes/life], or never smoked. Current smokers were classified by intensity of smoking, and were followed-up for incident stroke through 2015. The authors used Cox proportional hazard regression models to determine hazard ratios.

According to the results, after adjustment for cardiovascular risk factors, current black smokers were at a significantly higher risk for stroke than never-smokers (HR=2.48; 95% CI, 1.60 to 3.83), while there was no significant difference between former smokers and never-smokers (HR=1.10; 95% CI, 0.74 to 1.64). Those who smoked more intensely (20 or more cigarettes per day) had the highest risk for stroke (HR=2.78; 95% CI, 1.47 to 5.28) than less intense smokers (HR=2.28; 95% CI, 1.38 to 3.86), who still had twice the risk for stroke than never-smokers.

“Our findings support public health initiatives directed toward smoking cessation, especially among vulnerable groups like African Americans,” Adebamike Oshunbade, MD, MPH, lead study author and post-doctoral research fellow at the University of Mississippi Medical Center in Jackson, Mississippi, and fellow of the American Heart Association Tobacco Regulation and Addiction Center, said in a press release. “This is particularly important because these populations have been targeted by tobacco companies. More public enlightenment campaigns should be geared toward warning African Americans about the modifiable risk of developing stroke from cigarette smoking.”