Specific antismoking advice after stroke.

INTRODUCTION

Many stroke survivors would benefit from modification of their lifestyle in order to reduce their risk of recurrent stroke. We investigated if tailored smoking cessation advice would yield a higher smoking cessation rate and a higher rate with sustained abstinence in ex-smokers in the intervention group than among controls.

MATERIAL AND METHODS

Patients admitted with an acute stroke or a transient ischaemic attack were included in a randomised controlled trial focusing on control of lifestyle risk factors and hypertension. Here, we report the intervention focused on smoking cessation. We used multiple logistic regression analysis to identify patient characteristics associated with smoking cessation. Analyses were by intention to treat excluding those who died or suffered severe disease.

RESULTS

We included 254 patients with a history of smoking. Two years after inclusion, 15 of 57 (26%) baseline smokers in the intervention group had stopped smoking versus eight of 56 (14%) among controls (p = 0.112). Living with a partner (p = 0.012), having at least ten years of education (p = 0.012), and not being exposed to smoking at home (p = 0.036) were independent predictors of smoking cessation.

CONCLUSION

We did not achieve our aim of higher smoking cessation rates in the intervention group. Future smoking cessation interventions should be more intensive, focus on patients' social circumstances and, if possible, involve patients' relatives.

FUNDING

This study was supported by the Ludvig and Sara Elsass Foundation, the Lundbeck Foundation and The Danish Heart Foundation (Grant 07-4-B703-A1378-22384F).

TRIAL REGISTRATION

This protocol is registered with Clinical Trials.gov (NCT 00253097).