Predictors of Smoking Patterns After First Stroke

Abstract

Persistent smoking following stroke is associated with poor outcomes including development of secondary stroke and increased mortality risk. This study uses longitudinal data from the U.S. Health and Retirement Study (1992–2008) to investigate whether depression and duration of inpatient hospital care impact smoking outcomes among stroke survivors (N = 745). Longer duration of care was associated with lower likelihood of persistent smoking. Depression was associated with greater cigarette consumption. Interaction effects were also significant, indicating that for survivors who experienced longer inpatient care there was a weaker association between depression and cigarette consumption. Implications for practice and research are discussed.

Health-related quality of life profiles and their dimension-specific associated factors among Malaysian stroke survivors: a cross sectional study

“…On the other hand, smoking was associated with lower odds of having problems in the mobility dimension. In other words, persistent smoking was more commonly observed in those without mobility issues or who have better functional status as observed by other studies [ 56 , 57 ]. Financial constraints, mobility impairment and lack of social gathering might have restricted patients’ access to cigarettes supply since many were dependent on others for income sources or were having walking impairment during the survey.…”

Factors Associated with the Intention to Quit Smoking in Elderly Korean Men: The Korea National Health and Nutrition Examination Survey 2010-2015

“…23) Besides, some patients are seeking to overcome stress, depression, and pain from their illness by smoking, and some believe that smoking-related diseases are not caused by tobacco. [24][25][26] Since smoking-related diseases are caused by long-term smoking, patients suffering from these diseases are more addicted to nicotine than those suffering from other diseases. 23) Especially in COPD, patients continue to smoke because the respiratory symptoms progress slowly and are not severe enough to quit smoking.…”

“…A large proportion of patients with severe smoking-related diseases have no smoking cessation intention because they believe that it is too late to quit smoking after diagnosis as their health is already severely damaged [ 23 ]. Besides, some patients are seeking to overcome stress, depression, and pain from their illness by smoking, and some believe that smoking-related diseases are not caused by tobacco [ 24 - 26 ]. Since smoking-related diseases are caused by long-term smoking, patients suffering from these diseases are more addicted to nicotine than those suffering from other diseases [ 23 ].…”

The experience of continued smoking after stroke in Korean males: A qualitative study

“…Although study participants returned to their normal lives after hospital discharge, they still experienced anxiety owing to their health status; consequently, participants turned to a known comfort to relieve this anxiety by regaining physical and psychological composure: the cigarette. On the topic, a study showed that continued smoking is closely associated with psychological factors such as depression (McCarthy et al., 2013 ); another that smokers exhibit higher sensitivity to depression and stress recognition than nonsmokers (Kwon et al., 2016 ); and another that smokers tend to escape from negative emotions through smoking (Lee & Lee, 2015 ). Thus, stakeholders in the appropriate and effective care delivery for stroke patients should endeavour to assess and treat both psychological and physical factors, and the same can be said for other types of patients who experience the onset of serious diseases.…”

“…The major themes associated with continued smoking in people who relapsed were “ambivalent feelings” and “internal conflict over smoking versus non‐smoking” (Clancy et al., 2013 ; Uppal et al., 2013 ). However, unlike heart disease patients, stroke patients often exhibit accompanying cognitive or physical disorders that affect their activities of daily living (Kwon, Hong, et al., 2016 ), and such contexts can cause depression; a study on depression in patients within 2 years after stroke diagnosis showed that patients’ depression and tobacco consumption levels were significantly related (McCarthy et al., 2013 ). The factor that has been shown to influence continued smoking even after stroke diagnosis was male sex (Ives et al., 2008 ; Sienkiewicz‐Jarosz et al., 2009 ).…”