Smoking and Strokes


Cigarette smoking is one of the biggest risk factors for stroke. Yet the nicotine dependence combined with the habitual nature of smoking make it a powerful addiction that many smokers have tremendous difficulty giving up, even when you know how harmful your habit truly is.

How Does Cigarette Smoking Cause Stroke?

A number of different chemicals absorbed into the body through the inhalation of cigarette smoke induce harmful long-term and short-term changes in the blood vessels of the brain.

The speed of blood flow through the brain’s blood vessels changes during and shortly after smoking. Additionally, persistent injury to the lining of the cerebral blood vessels (blood vessels that supply the brain) can contribute to long-term blood vessel disease called cerebrovascular disease, which often results in stroke. Blood vessels in the brain become more predisposed to blockage and to the development of blood clots after repeated exposure to the chemicals inhaled via cigarettes.

Cigarette smoke produces variations in heart rate and heart function that may ultimately lead to stroke.

Smoking and Stroke

Smoking can contribute to the development of strokes as well as transient ischemic attacks (TIA's,), which are reversible mini strokes. Some people who suffer from strokes experience TIA warning signs ahead of time, while some individuals experience sudden, large permanent strokes without ever having TIA warning signs ahead of time. And TIA's are always an indication of a serious stroke risk.

Many smokers also suffer from silent strokes, which are small strokes that do not result in obvious neurological complaints. The problem with silent strokes, however, is that over time, a build up of too many silent strokes can overwhelm the brain's ability to function properly and may ultimately result in the abrupt onset of serious neurological problems, such as dementia.

Smokers who suffer from TIA’s, strokes or silent strokes remain at risk of recurrent or more severe strokes if they continue to smoke. Thus, a TIA or stroke should serve as a clear signal to smokers that there is stroke-producing damage developing in the body. The discovery of one or more silent strokes, similarly, should alert smokers that there is quiet, yet substantial injury emerging within the body.

Secondhand Smoke

Smoking has a dramatic impact on stroke incidence throughout the lifetime of the smoker. However, scientific research studies have also demonstrated that secondhand smoke increases stroke risk in non-smokers.

It was determined that the higher the second hand smoke exposure, the higher the likelihood of stroke. Non-smoking spouses of smokers, who are often exposed to high concentrations of secondhand cigarette smoke over many years, have a much higher incidence of stroke than people of similar health status who are not regularly exposed to secondhand smoke.

The Benefits of Quitting Cigarettes

Interestingly, the damage caused by smoking that leads to strokes has actually been proven to reverse 5-10 years after smoking cessation. This means that it is worthwhile to discontinue smoking, despite years of addiction and exposure. Even patients who have already experienced TIA's have been noted to reverse the damage of smoking years after discontinuing the habit, substantially reducing stroke risk.

It is important to note, however, that people who have already had a stroke do not see a fading of neurological symptoms as a result of smoking cessation. What happens is that there is a decreased risk of having another stroke when smokers cease the use of cigarettes. Similarly, smoking cessation cannot cure lung cancer if a person already has developed cancer. Therefore, it is best to stop smoking before serious health problems arise, and not to wait until afterwards.

Electronic cigarettes are relatively new and, at the current time, there is not enough data to determine with accuracy whether or not electronic cigarettes have a similar effect on stroke risk as traditional cigarettes.


Influence of smoking cigarettes on cerebral blood flow parameters, Kochanowicz J, Lewko J, Rutkowski R, Turek G, Sieskiewicz A, Lyson T, Mariak Z, Biological Research for Nursing, January 2015

Cigarette smoking and other risk factors for silent cerebral infarction in the general population, Howard G, Wagenknecht LE, Cai J, Cooper L, Kraut MA, Toole JF, Stroke, May 1998

Meta-analysis of the association between secondhand smoke exposure and stroke, Oono IP, Mackay DF, Pell JP, Journal of Public Health, December 2011

Smoking and Stroke, Hashimoto Y, Brain and Nerve, May 2011

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