Stephen Davis and Valery Feigin, on behalf of the World Stroke Organization
Stroke is a leading cause of death and disability, particularly in low and middle-income regions. Smoking is a major modifiable risk factor for stroke, with similar risk in women and men. Smoking (both active and passive) has been known as one of the most important risk factors for stroke for many years. In the most recent Global Burden of Disease 2015 Study, smoking was ranked the 5th most important risk factor for stroke accounting globally for almost 26 million disability-adjusted life years (DALYs) (23%) due to stroke, with the bulk of the burden (almost 22 million DALYs or 85% of stroke-related DALYs due to smoking) born in low- to middle-income countries. Smoking accelerates atherosclerosis in the cerebral arteries, an important cause of stroke.
While stroke-related DALYs due to second-hand smoking has decreased over the last 25 years (1990-2015) by 31%, global stroke burden attributable to smoking over the same time period has increased by >10%, and again, the bulk of the increase occurred in the low- to middle-income countries. There was a 25-fold geographical difference in the stroke burden attributable to smoking (refer to attached graph), with the highest burden in Nepal, Papua New Guinea, Indonesia, Mongolia and China.
Overall, smokers double their risk of suffering a stroke during their lifetime. The World Stroke Organisation therefore strongly endorses the efforts of the World Health Organisation to reduce tobacco-related illness and death.
Tobacco control measures could have a major impact on the global burden of stroke. Controlling tobacco use is a key part of the 2030 sustainable development goals, targeting a 30% reduction in premature deaths due to non–communicable diseases such as stroke, heart and lung diseases, cancer and diabetes. Stroke is reaching epidemic proportions in low and middle income countries and tobacco control could prevent millions of premature deaths and disability.
Stroke is highly preventable and tobacco control measures can have a great global impact.
WHO link to media centre report on tobacco measures and outcomes
WHO link to media centre report on tobacco measures and outcomes
