Abstract Details

Title Nationwide Racial Disparities in Smoking Cessation after Stroke in the United States

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S30 - Cerebrovascular Disease and Interventional Neurology 3 (4:40 PM-4:48 PM)

Poster/Presentation
Number 005

Background

Black Americans face a higher risk of recurrent stroke than White Americans, and the reasons are unclear. Smoking after stroke is associated with higher recurrent stroke risk. Disparities in smoking cessation may contribute to differences in recurrent stroke.

Objective This study aimed to determine if there are racial disparities in smoking cessation among stroke survivors.

Design/Methods We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, a nationally representative health survey. Data was pooled from 2013-2018, during which race and ethnicity were uniformly reported. Respondents with prior stroke and any smoking history were included. The exposure was self-reported race, and the outcome was smoking cessation. We calculated the quit ratio, conventionally defined as the proportion of former smokers among ever smokers. Survey procedures were used to estimate frequencies and summarize quit ratios by race. Multiple logistic regression was used to assess the association of Black race with smoking cessation, as compared to White race, while adjusting for age, gender, Hispanic ethnicity, education, income, health insurance, and smoking-related comorbidities.

Results Among 4,374,011 Americans with a history of stroke and any smoking, the median age was 67 years (IQR, 58-76), and 45.7% were women; 15.4% were Black, 74.8% were White, and 9.8% reported other race. The crude quit ratio was 51.4% (95% CI, 49.0-53.7) in Black and 63.2% (95% CI, 62.4-64.1) in White stroke survivors. In unadjusted analyses, Black stroke survivors were less likely to have quit smoking than White stroke survivors (OR, 0.61; 95% CI, 0.55-0.68). This remained the case after accounting for demographics and smoking-related comorbidities (OR, 0.85; 95% CI, 0.74-0.98).

Conclusions

In this nationwide study, Black stroke survivors had lower smoking quit rates than White stroke survivors, even after accounting for group differences. Expanding access to smoking-cessation interventions may reduce recurrent stroke disparities.

Authors/Disclosures
Neal S. Parikh, MD (Alnylam Pharmaceuticals) PRESENTER	Dr. Parikh has received personal compensation for serving as an employee of Alnylam Pharmaceuticals. Dr. Parikh has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for cases of neurological illness. Dr. Parikh has stock in Alnylam Pharmaceuticals. The institution of Dr. Parikh has received research support from Leon Levy Foundation. The institution of Dr. Parikh has received research support from Florence Gould Foundation. The institution of Dr. Parikh has received research support from NY State Empire Clinical Research Investigator Program. The institution of Dr. Parikh has received research support from NIA. The institution of Dr. Parikh has received research support from Medtronic.
Melvin Parasram, MD (NewYork-Presbyterian Hospital Queens)	Dr. Parasram has nothing to disclose.
	No disclosure on file
Saad A. Mir, MD (New York-Presbyterian Hospital/Weill Cornell Medical Center)	Dr. Mir has nothing to disclose.
Halina White, MD MA BA (Weill Cornell Medical Center)	Dr. White has nothing to disclose.
Babak Navi, MD (Weill Cornell Medical College)	Dr. Navi has nothing to disclose.
Hooman Kamel, MD (Weill Cornell Medical College)	Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.