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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1996 Dec;50(6):621–624. doi: 10.1136/jech.50.6.621

Smoking habits and risk of fatal stroke: 18 years follow up of the Oslo Study.

L L Håheim 1, I Holme 1, I Hjermann 1, P Leren 1
PMCID: PMC1060377  PMID: 9039379

Abstract

STUDY OBJECTIVE: To examine the risk of fatal stroke in relation to smoking habits in men screened for the Oslo study. DESIGN: The Oslo study is a prospective, cohort study of the epidemiology and preventive aspects of cardiovascular diseases in middle aged men. Screening started in May 1972 and results after 18 years of follow up are reported. PARTICIPANTS: There were 16209 men aged 40-49 years, of whom 16173 had no stroke history. Eighty five men died from stroke, of whom 48 were daily cigarettes smokers, 7 were pipe and cigar smokers, 15 smoked cigarettes and pipe or cigars daily, 11 were previous cigarette smokers, and 4 had never smoked cigarettes. MAIN RESULTS: Results of proportional hazards regression analysis adjusted for age, diastolic blood pressure, and glucose concentration showed the following rate ratios (RR) (95% confidence interval) of smoking groups compared with those who had never smoked or had previously smoked: combined cigarette and cigar or pipe smokers, RR = 6.1 (3.0, 12.5); cigarettes only, RR = 4.1 (2.3,7.4); and pipe and/or cigars only RR = 2.2 (0.9,5.5). The overall, age adjusted risk of smoking cigarettes daily was 3.5 and was found to increase with increasing cigarette consumption. Regardless of their smoking group, stroke cases had increased diastolic (DBP) and systolic blood pressure (SBP) when compared with men who had not had a stroke. The absolute differences in DBP and SBP between stroke cases and others for never and previous cigarette smokers versus daily smokers were twice as large: DBP, 12.1 mmHg versus 6.5 mmHg respectively and SBP, 16.0 mmHg versus 7.1 mmHg respectively. A high BMI increased the risk of fatal stroke of never and previous cigarette smokers. Men being treated for hypertension at the time of screening had three times the crude risk of fatal stroke of men who were not taking hypertensive treatment. CONCLUSIONS: Daily cigarette smoking increased the risk of fatal stroke three and a half times. Combined cigarette and pipe or cigar smoking had a higher risk than smoking cigarettes only. An increased risk was found in relation to increased daily cigarette consumption.

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Selected References

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  1. Abbott R. D., Yin Y., Reed D. M., Yano K. Risk of stroke in male cigarette smokers. N Engl J Med. 1986 Sep 18;315(12):717–720. doi: 10.1056/NEJM198609183151201. [DOI] [PubMed] [Google Scholar]
  2. Bonita R., Scragg R., Stewart A., Jackson R., Beaglehole R. Cigarette smoking and risk of premature stroke in men and women. Br Med J (Clin Res Ed) 1986 Jul 5;293(6538):6–8. doi: 10.1136/bmj.293.6538.6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Doll R., Peto R., Wheatley K., Gray R., Sutherland I. Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ. 1994 Oct 8;309(6959):901–911. doi: 10.1136/bmj.309.6959.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Donnan G. A., McNeil J. J., Adena M. A., Doyle A. E., O'Malley H. M., Neill G. C. Smoking as a risk factor for cerebral ischaemia. Lancet. 1989 Sep 16;2(8664):643–647. doi: 10.1016/s0140-6736(89)90894-5. [DOI] [PubMed] [Google Scholar]
  6. Hickey N., Mulcahy R., Daly L., Graham I., O'Donoghue S., Kennedy C. Cigar and pipe smoking related to four year survival of coronary patients. Br Heart J. 1983 May;49(5):423–426. doi: 10.1136/hrt.49.5.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Higa M., Davanipour Z. Smoking and stroke. Neuroepidemiology. 1991;10(4):211–222. doi: 10.1159/000110272. [DOI] [PubMed] [Google Scholar]
  8. Håheim L. L., Holme I., Hjermann I., Leren P. Nonfasting serum glucose and the risk of fatal stroke in diabetic and nondiabetic subjects. 18-year follow-up of the Oslo Study. Stroke. 1995 May;26(5):774–777. doi: 10.1161/01.str.26.5.774. [DOI] [PubMed] [Google Scholar]
  9. Håheim L. L., Holme I., Hjermann I., Leren P. Risk factors of stroke incidence and mortality. A 12-year follow-up of the Oslo Study. Stroke. 1993 Oct;24(10):1484–1489. doi: 10.1161/01.str.24.10.1484. [DOI] [PubMed] [Google Scholar]
  10. Juvela S., Hillbom M., Numminen H., Koskinen P. Cigarette smoking and alcohol consumption as risk factors for aneurysmal subarachnoid hemorrhage. Stroke. 1993 May;24(5):639–646. doi: 10.1161/01.str.24.5.639. [DOI] [PubMed] [Google Scholar]
  11. Leren P., Askevold E. M., Foss O. P., Froili A., Grymyr D., Helgeland A., Hjermann I., Holme I., Lund-Larsen P. G., Norum K. R. The Oslo study. Cardiovascular disease in middle-aged and young Oslo men. Acta Med Scand Suppl. 1975;588:1–38. [PubMed] [Google Scholar]
  12. Robbins A. S., Manson J. E., Lee I. M., Satterfield S., Hennekens C. H. Cigarette smoking and stroke in a cohort of U.S. male physicians. Ann Intern Med. 1994 Mar 15;120(6):458–462. doi: 10.7326/0003-4819-120-6-199403150-00002. [DOI] [PubMed] [Google Scholar]
  13. Shinton R., Beevers G. Meta-analysis of relation between cigarette smoking and stroke. BMJ. 1989 Mar 25;298(6676):789–794. doi: 10.1136/bmj.298.6676.789. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wolf P. A., D'Agostino R. B., Kannel W. B., Bonita R., Belanger A. J. Cigarette smoking as a risk factor for stroke. The Framingham Study. JAMA. 1988 Feb 19;259(7):1025–1029. [PubMed] [Google Scholar]
  15. Zeiner-Henriksen T., Lund E. Røking og mortalitetsrisiko blant middelaldrende menn i Norge. Tidsskr Nor Laegeforen. 1985 Feb 20;105(5):353–357. [PubMed] [Google Scholar]

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