SMOKING CESSATION AND DECREASED RISK OF STROKE IN WOMEN

Objective.-To prospectively examine the relationship of time since stopping smoking with risk of stroke in middle-aged women. Design.-An ongoing prospective cohort of women with 12 years' follow-up data (1976 to 1988), in which information on smoking habits was updated every 2 years by postal questionnaire. Population Studied.-A total of 117 006 female registered nurses aged 30 to 55 years in 1976 and free of coronary heart disease, stroke, and cancer at baseline. Main Outcome Measures.-Incident strokes (fatal and nonfatal), further subdivided into ischemic stroke, subarachnoid hemorrhage, and cerebral hemorrhage. Results.-The age-adjusted relative risk of total stroke among current smokers compared with never smokers was 2.58 (95% confidence interval, 2.08 to 3.19). The corresponding relative risk among former smokers was 1.34 (95% confidence interval, 1.04 to 1.73). For total and ischemic stroke, the excess risks among former smokers largely disappeared from 2 to 4 years after cessation. The same patterns of decline were observed regardless of number of cigarettes smoked, the age at starting, or the presence of other risk factors for stroke. Conclusions.-The risk of suffering a stroke among cigarette smokers declines soon after cessation and the benefits are independent of the age at starting and the number of cigarettes smoked per day.