Among stroke survivors who smoke, e-cigarette users more likely to quit
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Nearly 14% of active smokers who survived a stroke use e-cigarettes, and those users were more inclined than e-cigarette nonusers to try to quit smoking within the past year, according to a research letter published in JAMA Neurology.
“E-cigarette use is increasingly common, so we were motivated to understand the extent to which e-cigarette use is an unaddressed risk factor among stroke survivors. We also wondered whether stroke survivors are using e-cigarettes to help them quit smoking regular cigarettes,” Neal S. Parikh, MD, MS, assistant professor of neurology and neuroscience at Weill Cornell Medicine, told Healio.
“The key take-home messages are that stroke survivors frequently use both regular and e-cigarettes, so their doctors need to ask specifically about e-cigarette use,” Parikh said.
In a cross-sectional analysis, researchers used pooled data from the 2016-2018 CDC Behavioral Risk Factor Surveillance System surveys.
The researchers analyzed a cohort of 6,867,786 stroke survivors (mean age, 60 years), of whom 23.6% (95% CI, 22.7-24.5) were active smokers.
Among actively smoking stroke survivors, 49.2% were women, 22.2% lived in the Stroke Belt (Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Virginia) and 65.7% were white, the researchers wrote.
Researchers observed that diabetes was present in 27.9% (95% CI, 25.9-29.9) and hypertension in 65.6% (95% CI, 61.9-69.2) of stroke survivors.
The frequency of active e-cigarette use was 13.5% (95% CI, 11.8-15.3), and among active smokers, 62.3% (95% CI, 60.2-64.4) reported that they tried to quit smoking within the past year, according to the researchers.
Compared with smokers who did not use e-cigarettes, e-cigarette users were more likely to have attempted to quit cigarette smoking (users, 73%; 95% CI, 67.2-78.9; nonusers, 60.7%; 95% CI, 58.5-62.9; OR = 1.63; 95% CI, 1.21-2.19).
“Doctors should ask, ‘Are you using e-cigarettes to help you quit smoking regular cigarettes?’ and then provide patients with guideline-recommended smoking-cessation resources and should refer their patients with persistent smoking to tobacco treatment specialists who can provide dedicated attention,” Parikh told Healio.
For more information:
Neal S. Parikh, MD, MS, can be reached at nsp2001@med.cornell.edu.
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