Good morning, I'm Andrew Pipe from
the Minto Prevention and Rehabilitation Center at
the University of Ottawa Heart Institute in Ottawa, Canada.
It's my pleasure to greet you this morning
to begin a conversation about smoking and stroke,
with an emphasis on the best practices for your patients.
It's important to understand that of all of
the clinical interventions that can be delivered from a preventive perspective,
nothing is as powerful in any clinical setting as smoking cessation.
Unfortunately, when we address smoking cessation
we have to confront a variety of outmoded misconceptions,
prejudicial attitudes, and frank misunderstandings about the basis of smoking,
smoking behavior, and approaches to smoking cessation.
I term these "the zombie concepts";
concepts which are difficult to kill off
and which get in the way of our being able to
effectively help those of our patients who are smokers.
Although stroke is sometimes referred to as a cerebrovascular accident, it's no accident.
Approximately, 75 percent of all strokes
can be attributed to an adverse risk factor profile.
It's also important to recognize that it's been suggested that it's difficult to
identify any other condition that represents such a mixture of lethality,
prevalence, and neglect as does tobacco addiction.
All of them are ironic,
given that we have an array of
effective and readily available interventions in the 21st century.
So, as far as stroke is concerned,
there's a very strong relationship between
cigarette smoking and ischemic stroke risk in young women.
Spousal smoking poses a very important stroke risk for never-smokers and former smokers.
We know that current or recent smokers experience
poorer stroke outcomes than do nonsmokers three months after an acute ischemic event.
We know that in people who have experienced a stroke,
they have doubled the risk of mortality compared to
non-smokers and ex-smokers in exactly the same clinical state.