Ives Sharon P, Heuschmann Peter U, Wolfe Charles D A, Redfern Judith
Division of Health & Social Care Research, King's College London, London, UK.
Eur J Cardiovasc Prev Rehabil. 2008 Jun;15(3):329-35. doi: 10.1097/HJR.0b013e3282f37a58.
Stroke survivors are at high risk of recurrent strokes and other vascular events. Smoking is an established risk factor for stroke, with cessation recommended for secondary prevention. Little is known about patterns of smoking cessation after stroke.
A prospective cohort of patients was identified.
Data were derived from the population-based South London Stroke Register. Self-reported smoking status was measured at the time of stroke, at 3 months, and at 1 and 3 years after stroke. Stroke survivors, who were smoking at the time of stroke and were alive 3 years later, were included. Logistic regression was used to examine associations between age, sex, ethnicity, socioeconomic status, risk factors, stroke subtype, disability, and probability of attempting and maintaining smoking cessation.
Complete smoking data were available for 363 survivors with strokes between 1995 and 2003. In all, 71% of the smokers had attempted to quit within 3 years; 30% had quit and maintained cessation at 1 and 3 years; 10% had quit immediately after stroke, but had subsequently relapsed (smoking again at 1 and 3 years); and 25% of the smokers had quit after 3 months. Black ethnicity [odds ratio (OR): 6.20; confidence interval (CI): 2.39-16.10] and more severe disability (P=0.035) were predictors of attempts to quit. Older age (OR: 0.30; CI: 0.13-0.71) and black ethnicity (OR: 0.30; CI: 0.15-0.60) reduced the likelihood of smoking at 3 years. Among those attempting cessation, being older predicted maintenance (OR: 4.50; CI: 1.50-13.51).
The majority of smokers had attempted to quit after stroke; however, a minority achieved sustained cessation in the longer term. Cessation patterns are complex, and interventions should be targeted at multiple time points.
中风幸存者再次中风及发生其他血管事件的风险很高。吸烟是已确定的中风危险因素，建议戒烟以进行二级预防。关于中风后戒烟模式的了解甚少。
确定了一个前瞻性患者队列。
数据来自基于人群的南伦敦中风登记册。在中风时、3个月时以及中风后1年和3年测量自我报告的吸烟状况。纳入中风时吸烟且3年后仍存活的中风幸存者。使用逻辑回归分析年龄、性别、种族、社会经济地位、危险因素、中风亚型、残疾情况与尝试戒烟并维持戒烟的概率之间的关联。
1995年至2003年间发生中风的363名幸存者有完整的吸烟数据。总体而言，71%的吸烟者在3年内曾尝试戒烟；30%在1年和3年时已戒烟并维持戒烟状态；10%在中风后立即戒烟，但随后又复发（在1年和3年时再次吸烟）；25%的吸烟者在3个月后戒烟。黑人种族（比值比[OR]：6.20；置信区间[CI]：2.39 - 16.10）和更严重的残疾（P = 0.035）是尝试戒烟的预测因素。年龄较大（OR：0.30；CI：0.13 - 0.71）和黑人种族（OR：0.30；CI：0.15 - 0.60）降低了3年时吸烟的可能性。在尝试戒烟者中，年龄较大是维持戒烟的预测因素（OR：4.50；CI：1.50 - 13.51）。
大多数吸烟者在中风后曾尝试戒烟；然而，从长期来看，少数人实现了持续戒烟。戒烟模式复杂，干预措施应针对多个时间点。
