Not only are smokers twice as likely to have strokes, they are almost a decade younger than non-smokers when they have them, according to a study presented at the Canadian Stroke Congress.

Between January 2009 and March 2011, researchers studied 982 stroke patients (264 smokers and 718 non-smokers) at an Ottawa prevention clinic. They found the average age of stroke patients who smoked was 58, compared to age 67 for non-smokers.

"The information from this study provides yet another important piece of evidence about the significance of helping people stop smoking," said Dr. Andrew Pipe of the University of Ottawa Heart Institute, one of the study's authors. "It also alerts the neurology community to the importance of addressing smoking in stroke patients."

Smoking causes a build-up of debris on the inside of blood vessels, a condition called atherosclerosis, and it contributes to a higher likelihood of clots forming, said Dr. Pipe.

The Ottawa Hospital study, led by principal investigators Dr. Mike Sharma and Dr. Robert Reid, found smokers have double the risk of a stroke caused by a dislodged blood clot (ischemic stroke) and four times the risk of a stroke caused by a ruptured blood vessel (hemorrhagic stroke) than the non-smoking population.

In addition, smokers have a greater chance of having more complications and recurrent strokes. Patients who have had a minor stroke are 10 times more likely to have a major stroke, especially if they continue to smoke, said Dr. Pipe.

"It's scandalous that Canadians continue to die in large numbers from stroke, heart disease, cancers and a host of other diseases for which the tobacco industry is responsible," Dr. Pipe said.

If a person stops smoking, their risk for stroke or heart disease decreases. Within 18 months to two years of quitting, the risks of stroke are about the same as for non-smokers, said Dr. Pipe.

Some of the initiatives Dr. Pipe hopes to see enforced are to:

• reduce tobacco access to minors
• ensure tobacco is appropriately priced
• act more aggressively to deal with contraband tobacco
• be more systematic, from a health system's point of view, in terms of helping those who are smokers quit
• create an integrated smoking cessation unit within the health community

"Stroke is preventable," said Dr. Sharma, Deputy Director of the Canadian Stroke Network. "This study highlights the sizeable role smoking has on stroke. Quitting smoking, controlling blood pressure, following a healthy diet and being physically active significantly reduce the risk of stroke."

According to the Heart and Stroke Foundation, more than 37,000 Canadians will die prematurely each year due to tobacco use. Heart and Stroke Foundation spokesperson Dr. Michael Hill notes that this study reinforces the importance of education, prevention programs, and legislation. "It is critical for governments to continue to wage the battle against tobacco industry products," says Dr. Hill. "This includes the renewal of the Federal Tobacco Control Strategy, which is set to expire next spring, and ensuring that Canada adopts plain and standardized tobacco packaging."