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"There is a strong dose-response relationship between the daily quantity of cigarettes smoked and ischemic stroke risk in young women, one that reinforces the need for aggressive smoking-cessation efforts in young adults," said John Cole, MD, cor

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“There is a strong dose-response relationship between the daily quantity of cigarettes smoked and ischemic stroke risk in young women, one that reinforces the need for aggressive smoking-cessation efforts in young adults,” said John Cole, MD, corresponding author of the study and an assistant professor of neurology at the University of Maryland School of Medicine in Baltimore.

As part of the Stroke Prevention in Young Women study, researchers found for:

*1–10 cigarettes smoked a day, stroke risk increased 2.2 times.

*11–20 cigarettes smoked a day, stroke risk increased 2.5 times.

*21–39 cigarettes smoked a day, stroke risk increased 4.3 times.

*40 or more cigarettes smoked a day, stroke risk increased 9.1 times.

Researchers found that any smoking at all more than doubles the risk of stroke. “The odds ratio comparing current smokers to never smokers was 2.6 times greater,” said Dr Cole, who is also a clinical research scientist at Baltimore Veterans Affairs Medical Center and a neurologist at the University of Maryland Medical Center.

Comparing former smokers and never smokers showed no difference in the odds ratio, Dr Cole said.

The population-based case-control study followed 466 women (15–49 years old) who had suffered their first stroke. The control group consisted of 604 women free of stroke of similar age and race/ethnicity identified by random digit dialing.

A detailed smoking history was obtained during face-to-face interviews. Women were classified according to their smoking status as never smokers, former smokers, and current smokers. The 500 never smokers were defined as those who had not smoked more than 100 cigarettes or five packs of cigarettes in their lifetime.

The 386 current smokers were defined as those who had smoked more than 100 cigarettes in their lifetime and also had smoked in the 30 days preceding their stroke (for cases) or their interview (for controls). The 184 former smokers were defined as those who had smoked more than 100 cigarettes in their lifetime but had not smoked in the 30 days prior to their stroke/interview (cases/controls).

Data on measurements of serum nicotine or other markers for objectively validating smoking status were not available.

“Our study adds strong evidence that cutting down helps reduce stroke risk, but quitting is unquestionably the best option,” Dr Cole said.

In 2005, an estimated 20.7 percent of US women ages 18–24 were current cigarette smokers, researchers said.

Dr Cole said a similar study on young men is planned.

According to the American Heart Association:

*Cigarette smoking is the most important preventable cause of premature death in the United States. It accounts for nearly 440,000 of the more than 2.4 million annual deaths.

*Stroke is the third-leading cause of death, behind heart disease and cancer, and is the leading cause of serious, long-term disability in the United States. In 1999, about 1.1 million Americans reported difficulties with daily living because of a stroke.

*Each year, about 800,000 people suffer a stroke.

Locally, teen smoking and its many related risks is a concern to Newtown Youth & Family Services. Executive Director Beth Agen told The Newtown Bee this week that the agency supported a school based smoking cessation program last year, and she is hoping to present another one in the coming school year.

“I would hope that our new Substance Abuse Counselor, Martha Shilstone, will do the same (program as last year), but her first day isn’t until Friday of this week, so I cannot confirm,” Ms Agen said. “It is certainly something that NYFS endorses wholeheartedly.”

For those looking to quit now, Danbury Hospital is among the regional health care organizations offering its own smoking cessation program, as well as referrals to alternate programs like acupuncture and hypnotherapy.

The hospital’s six-week “Quit Now” smoking cessation program is administered by Marianne Mitchell, RN, APRN, a nurse practitioner with more than 12 years of experience treating and supporting people with chronic obstructive pulmonary disease. She previously served as the Hospital’s pulmonary rehabilitation coordinator and is a certified instructor of the American Lung Association’s Freedom from Smoking program.

During the “Quit Now” program, Ms Mitchell uses a combination of medication therapy, behavior modification, and ongoing support services to help more people quit smoking. She also provides consultation/assessment, counseling, treatment planning, group programs and the “Stay Quit” group, which helps with relapse prevention by providing ongoing support.

The National Institute of Neurological Disorders and Stroke, the National Institute on Aging, the Department of Veterans Affairs, and the American Heart Association partly funded the aforementioned stroke study. Disclosures for individual authors are available in the manuscript.

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