Smoking Cessation 1 Year Poststroke and Damage to the Insular Cortex

• Published in: Stroke (1970) Vol. 43; no. 1; pp. 131 - 136
• Main Authors: SUNER-SOLER, Rosa, GRAU, Armando, EUGENIA GRAS, Maria, FONT-MAYOLAS, Sílvia, SILVA, Yolanda, DAVALOS, Antonio, CRUZ, Verónica, RODRIGO, Joana, SERENA, Joaquin
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 2012
• Subjects: Adult; Aged; Biological and medical sciences; Cerebral Cortex - pathology; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Neurology; Neuropharmacology; Pharmacology. Drug treatments; Prospective Studies; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Smoking - pathology; Smoking Cessation; Stroke - pathology; Vascular diseases and vascular malformations of the nervous system; cortex; Stroke; Nervous system diseases; Tobacco smoking; motivation; Cardiovascular disease; Cerebral disorder; Encephalon; Vascular disease; Central nervous system disease; cessation; smoking; Insular cortex; Cerebrovascular disease; cerebral
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.111.630004

Hospitalization as a result of stroke provides an opportunity to stop smoking that is often not taken up. The present study analyzes sociodemographic, psychological, and lesion-related variables to identify associated factors for smoking cessation during the first year after stroke.
We conducted a prospective longitudinal study with a 1-year follow-up of a cohort of 110 patients with acute stroke who were smokers at the time of diagnosis and were admitted consecutively between January 2005 and July 2007.
On hospital release, 69.1% had given up smoking but at 1 year, only 40% had stopped smoking. Of the 110 patients, 27 (24.5%) had an acute stroke lesion in the insular cortex, of which 19 (70.3%) were nonsmokers at 1 year. Strongly associated factors in giving up smoking were the location of the lesion in the insular cortex (OR, 5.42; 95% CI, 1.95-15.01; P=0.001) and having the intention of giving up before the stroke, comparing precontemplating patients (without intention of giving up in the near future) with contemplating and prepared patients (intention of stopping in the near future; OR, 7.29; 95% CI, 1.89-28.07; P=0.004).
Of patients with stroke who were smokers, only 4 of 10 patients had stopped smoking 1 year after admission. Our results show that the variables best predicting smoking cessation in patients with a stroke diagnosis 1 year after hospital discharge are insular damage and the prestroke intention to stop.