Abstract WMP111: Trends in Active Tobacco Smoking Among Stroke Survivors in The United States: An Analysis of the National Health and Nutrition Examination Survey, 1999-2016

Abstract

Background: Active smoking after stroke is associated with worse outcomes. Since several smoking cessation drugs have become available during the last two decades, we sought to determine whether the rate of active smoking among stroke survivors has decreased. Methods: We performed a trends analysis using cross-sectional data from all nine available consecutive cycles of the continuous phase of the National Health and Nutrition Examination Survey from 1999 to 2016. Participants in each cycle were asked about their medical history and health-related behaviors. We included participants 20 years of age and older who answered questions regarding smoking. Patients with prior stroke were identified based on self-report, which has been validated against expert chart review. Active smoking was defined based on self-report. We used multivariable logistic regression methods for survey data to assess for trends in active smoking among all participants and those with prior stroke. Models were adjusted for demographics. Results: We included 49,440 participants in our analysis, of whom 1,921 (2.7%) reported a prior stroke. The mean age of stroke survivors was 64.8 (standard error, 0.5) years, and 57% were women. The average prevalence of active smoking over 1999-2016 was 22.2% for the whole sample and 24.3% among stroke survivors. In the overall population, the adjusted prevalence of active smoking decreased over the study period (odds ratio [OR] per cycle, 0.96; 95% confidence interval [CI], 0.94-0.97). The rate did not decrease among stroke survivors (OR, 1.01; 95% CI, 0.93-1.09) (Fig). Conclusion: Despite the availability of several effective smoking cessation therapies, the rate of active smoking among stroke survivors has not decreased in the past two decades. Effective strategies for smoking cessation for secondary stroke prevention are needed.