Smoking not only increases your risk of health problems, such as heart disease and blocked arteries, it’s also strongly linked to stroke. But there are many different factors that can affect your risk, from gender to financial status. Here are some fascinating facts about smoking and stroke…

1. A smoker is 3-4 times more likely to suffer a stroke

Did you know? Men who smoke are three times more likely to die aged 45-64 years, and twice as likely to die aged 65-84 years than non-smokers. Stopping smoking dramatically reduces these statistics, but it all depends on the length of time you give up cigarettes (1, 2).

2. You are twice as likely to die from a stroke if you smoke

Your chance of dying from stroke varies greatly according to where you live in Europe due, in part, to the vast differences in stroke services available (3). Regardless of this, studies show people who choose to smoke have almost double the risk of suffering a stroke than those who don’t and are also twice as likely to die from it (4).

3. Up to 10% of stroke cases worldwide are caused by smoking

According to the World Health Organisation, smoking is thought to cause around 10% of cardiovascular disease worldwide. In 2008, the highest overall prevalence for smoking was estimated to be in the European Region, at nearly 29%. (5) Thankfully, in Europe, the death rate has fallen significantly over the last two years, but the number of people living with disabilities, as a result of stroke, continues to be a huge problem (6).

4. Up to 75% of some low-income groups smoke

Wherever you are in the world, the prevalence of smoking seems to be highest amongst those on low incomes. In some of the poorest parts of the UK, smoking rates as high as 75% have been reported (7). In many countries around the world, the poorest men are over 2.5 times more likely to smoke than the richest men and, of course, poorer communities also have the worst access to stroke care (8).

5. Stroke risk is also almost double for passive smokers

Even being exposed to tobacco smoking at home or at work, could be a risk factor for stroke. One study suggests it may even be similar to actively smoking, for which the risk is doubled. Research into people with partners who smoke found the odds of a first stroke were increased for ex-smokers and non-smokers exposed to second-hand smoke (1).

6. Tobacco contains over 4,000 different chemicals

We’ve all seen those horrible pictures of lungs covered in tar. Well, imagine what that toxic tobacco is doing to your brain. Tobacco smoke contains over 4,000 different chemicals, including heavy metals and other toxins, that promote the development of ‘free radicals’. Over time, this can cause inflammation in the brain and lead to stroke (1).

7. Up to one quarter of all strokes are directly attributable to smoke

Research suggests strokes caused directly by smoking could amount to almost a quarter of all recorded strokes (1). With the total cost of stroke in Europe estimated at €45 billion, imagine how much of our healthcare budgets could be saved if every single person gave up smoking (6).

8. 10 modifiable risk factors account for around 90% of the risk of stroke.

Along with poor diet; high blood pressure; obesity; diabetes; lack of physical exercise; excessive alcohol consumption; high cholesterol; heart disease and depression; smoking is one of ten risk factors associated with stroke. The good news is: these are all things you can change. Stop smoking and you’ll almost certainly reduce your risk of stroke (9).


1. Reena S. Shah, John W Cole. (2010). Smoking and stroke: the more you smoke the more you stroke. Expert Rev Cardiovasc Ther., 8 (7): 917-932. Doi: 10.1586/erc.10.56.

2. Kawachi I, Colditz GA, Stampfer MJ, Willett WC, Manson J e, Rosner B, et al. (1993). Smoking cessation in relation to total mortality rates in women. A prospective cohort study. Ann Intern Med., 9(0):992-1000.

3. [Accessed August 2018]

4. James F. Meschia, MD et al. (2014). Guidelines for the Primary Prevention of Stroke. A statement for healthcare professionals from the American Heart Association/American Stroke Association. DOI: 10.1161/STR.0000000000000046. Stroke, 45: 3754-3832.

5. Thun MJ, Apicella LF, Henley SJ. (2000). Smoking vs other risk factors as the
cause of smoking-attributable deaths: confounding in the courtroom. JAMA, 284:706–712


7. Marsh A, Mckay, S. Poor smokers. London; Policy Studies Institute: 1994.

8. Ahmad Reza Hosseinpoor, Lucy Anne Parker, Edouard Tursan d/Espaignet, Somnath Chatterji. (2012). Socioeconomic Inequality in Smoking in Low-income and Middle-income Countries: Results from the World Health Survey, Doi: 10.1371/journal.pone.0042843

9. Xianwei Zeng, Aijun Deng, Yi Ding. The INTERSTROKE study on risk factors for stroke. Doi: (16) 32620-4