How much does smoking or tobacco use increase your risk of stroke? Should you be concerned?

Jump to: How does tobacco cause a stroke?Am I at risk of having a stroke?

Important: Do you fear someone you’re with is currently experiencing a stroke? See warning signs below and call 9-1-1 immediately.


What is a stroke?

A stroke occurs when the blood vessels to (and within) the brain become blocked or burst open. This prevents areas of the brain from getting oxygen and vital nutrients. Within minutes, parts of the brain can begin to die. Strokes can cause permanent brain damage, long-term disability, and in some cases, even death.

There are two types of strokes: ischemic and hemorrhagic. Ischemic strokes are the most common type of strokes and occur when a major blood vessel in the brain is blocked by either a blood clot or plaque buildup. Hemorrhagic strokes occur when a blood vessel in the brain bursts and begins to spill blood into nearby tissues. These tend to cause more damage than ischemic strokes.

People can also experience a Transient ischemic attack (TIA) or a “mini stroke”. These episodes only last a few minutes, but can be an important warning about your potential for experiencing an actual stroke. Almost 1 in 3 people who experience TIAs will eventually have a stroke, often within a year of experiencing a TIA.

Symptoms of a TIA include:

  • Weakness, numbness, or paralysis in the face, arms, and legs – often affecting one side of the body
  • Slurred speech or difficulty understanding others
  • Blindness or double vision in one or both eyes
  • Vertigo, loss of balance, and/or coordination

Strokes are the second leading cause of death worldwide and the fifth highest cause of death in the United States. Strokes are also one of the leading causes of disability around the world.

What are the possible impacts of a stroke?

The effects of a stroke often depend on the area of the brain where it has occurred and how much brain tissue has been affected. However, some of the most common effects of strokes include changes to speech, difficulty learning and understanding, and weakness or paralysis on one side of the body.

Possible physical changes: Possible emotional and/or personality changes: Possible thinking, memory, & perception changes:
  • Difficulty gripping and/or holding items
  • Fatigue or tiredness
  • Incontinence
  • Pain
  • Difficulty performing physical activities or exercising
  • Issues with swallowing
  • Issues with vision
  • Weakness or paralysis on one side of the body
  • Depressive thoughts or feelings
  • Experiences with anxiety or anxiety episodes
  • Behavioral changes like:
    • Irritability
    • Aggressiveness
    • Apathy
    • Repetitive Behavior
    • Disinhibition
    • Impulsiveness
  • Ability to learn new skills
  • Ability to plan
  • Problem solving
  • Ability to concentrate/focus
  • Orientation
  • Short-term memory

Having a stroke can impact your physical health and mental/emotional health, as well as your ability to do everyday tasks. People who have suffered a stroke must often make changes to their lifestyles like living arrangements, relationships with partners, using complex skills (like driving), working, and the level of independence they maintain.

How does smoking or tobacco use contribute to the risk of stroke?

Tobacco smoke contains more than 7000 chemicals, at least 250 of which are known to be harmful, which transfer into your bloodstream and are transported around your body. These chemicals can cause serious damage to your cells, affecting your circulatory system and increasing your risk of having a stroke.

It is estimated that people who smoke are at an increased risk (2-4 times higher) of having a stroke when compared to people who do not smoke. Smoking and tobacco use can:

  • Cause blood to become stickier and more likely to clot. This increases the likelihood of blocking blood flow, especially to the brain
  • Increase your chances of developing cardiovascular disease (CVD) which can lead to a stroke
  • Increase the triglycerides (a type of fat) in your blood
  • Lower the “good” cholesterol in your blood
  • Reduce oxygen levels in your blood
  • Increase plaque buildup in blood vessels, narrowing the insides of the vessels
  • Cause the arteries to become thicker and stiff (atherosclerosis).

What about smokeless tobacco and other tobacco products?

Alternative forms of tobacco are often portrayed as “less harmful” than cigarettes, but this is not true. Smokeless products like chew, snuff, and dissolvable tobacco still contain nicotine as well harmful substances which may increase your heart rate and blood pressure. E-cigarette use, or vaping, has also been shown to damage the cardiovascular system. Sustained increases in both heart rate and blood pressure can increase the risk for death from stroke.

Secondhand smoke & stroke

Even individuals who don’t smoke can be affected by the negative consequences of tobacco use. People who don’t smoke, but are exposed to secondhand smoke, are at an increased risk (20 – 30% higher) for stroke. In the US, upwards of 8,000 deaths per year from stroke are caused by secondhand smoke. Exposure to secondhand smoke also increases your risk of experiencing other medical issues like heart attacks. 

Am I at risk of having a stroke?

Anyone at any age can experience a stroke. Your level of risk depends on a number of factors. While some risk factors for strokes can be changed, others cannot. Risk factors for stroke like high blood pressure (HBP), heart disease, diabetes, smoking or tobacco use can be managed or treated. Other risk factors like age, race, gender, history of stroke, and hereditary/genetics cannot be changed. Learn more about the additional risk factors here.

One of the ways to decrease your chances of suffering from a stroke is to not smoke or use tobacco products at all. People who quit smoking see an immediate improvement in their oxygen, carbon monoxide, and nicotine levels and within five years, their risk of suffering from a stroke is half that of someone who smokes. Another good way to reduce your risk of stroke is to follow the ABCs of heart health

Lower your risk of stroke

Changes in certain lifestyle choices can decrease your risk. In addition to quitting smoking, these include avoiding secondhand smoke, eating a low-fat, low-salt diet, maintaining a healthy weight, exercising regularly, limiting your alcohol use and making sure other health conditions like diabetes are under control. Speak with your doctor about any concerns you may have or what you can do to reduce your chances of suffering from a stroke.

Signs that someone is having a stroke

During a stroke, every minute is important! If you are unsure, call 9-1-1.

  • Sudden numbness or weakness in areas like the face, arms, or legs. This usually affects one side of the body
  • Sudden confusion, issues with speaking, or difficulty understanding speech
  • Sudden vision impairment in one or both eyes
  • Sudden trouble walking, lack of coordination, dizziness, or loss of balance
  • Sudden severe headache without a cause

If you believe someone is having a stroke, act F.A.S.T. and complete the following test:

  • F – Face: Ask the person to smile. Look to see if one side of their face droops
  • A – Arms: Ask the person to raise both arms. Look to see if one arm drifts downward
  • SSpeech: Have the person repeat a simple phrase. Is the speech slurred or strange?
  • T – Time: If you see ANY of these signs, call 911 right away

It is important to note the time that any symptoms appear. This information will help medical providers determine the best pathway for treatment.

Bottom Line:

It is a known fact that smoking and other tobacco products increase your chances of having a stroke. Instead of taking that chance, refrain from using any type of tobacco products and help to reduce your risk of suffering from a stroke.



If you’re considering quitting tobacco

If and when you are interested in quitting, help is available, free of charge, including medication and counseling support from QuitNow-NH. Speak with your doctor at your next visit, or visit our quitting page to learn more and get started.