Smoking Dramatically Raises Risk of Stroke for Black Americans

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Researchers say smoking can more than double the risk of stroke for Black Americans who already face higher risks due to diet, healthcare access, and air pollution. Getty Images

There’s a lot that scientists already know about stroke risk for Black Americans.

Blacks, for example, are nearly twice as likely as whites to have a stroke and die from it.

However, researchers say there has been little data on what role smoking plays in stroke risk for Black Americans.

Now, a new study published in the Journal of the American Heart Association has some answers.

The research, partially funded by the National Institutes of Health (NIH), concluded that the risk of stroke may more than double for Black Americans who smoke.

Researchers add the risk gets higher with the number of cigarettes that are smoked.

“The more you smoke, the more you stroke,” said Dr. Adebamike Oshunbade, MPH, the study’s lead author and postdoctoral research fellow at the University of Mississippi Medical Center. “If you smoke more than a pack a day, your risk is even greater.”

The research team used data from participants in the Jackson Heart Study, the largest study in the United States looking at cardiovascular risk factors in Black Americans.

Of the group they evaluated, 546 participants were current smokers. Another 781 were past smokers and 3,083 had never smoked.

After accounting for other risk factors such as high blood pressure, diabetes, age, and high cholesterol, the researchers found that the stroke risk was 2.5 times higher for current smokers compared with people who never smoked.

Researchers also found the risk was “dose dependent.” For those who smoked more than 20 cigarettes a day, their stroke risk was 2.8 times greater.

However, the scientists found there was no significant difference between smokers who had quit and people who had never smoked. The researchers say that suggests smoking cessation may have potential benefits in reducing the incidence of stroke in Black Americans.

“It’s important to communicate the risk to vulnerable populations, especially with the growing popularity of new tobacco products,” Oshunbade told Healthline. “More public enlightenment campaigns should be geared toward warning African Americans about this modifiable risk.”

Ultrasound imaging tests also showed fatty plaque buildup in the carotid arteries leading to the brains of Black Americans.

“We found accelerated buildup of fatty plaques in some of the major blood vessels of the brains of smokers, which could play a role in the development of stroke among African Americans,” Oshunbade explained.

Hypertension, diabetes, age, obesity, and lack of exercise are stroke risk factors you’ve likely heard about.

But experts say socioeconomic risk factors are also crucial and too often disproportionately affect communities of color.

“One of them is decreased access to healthcare,” said Dr. George P. Teitelbaum, an interventional neuroradiologist and director of the Pacific Stroke and Aneurysm Center at Providence Saint John’s Health Center in Santa Monica, California.

A 2017 report from the NIH on health disparities said African Americans and Hispanics are more likely to be uninsured throughout adulthood than whites.

They’re also less likely to get preventive care and have a regular physician.

“Another is air pollution. It has been reported in recent studies to be a major risk factor in stroke,” Teitelbaum told Healthline. “Communities of color are impacted more often than those of Caucasians in the effects of air pollution because of where they live.”

According to the American Lung Association’s 2020 “State of the Air” report, more than 14 million people of color in the United States live where they’re subjected to both short-term and year-long air pollution.

The locations are often near industrial districts and affect Hispanics, Asians, Native Americans, and African Americans.

“Stroke is also increased with heavy alcohol use. There are a number of liquor stores per square mile in poorer neighborhoods,” Teitelbaum added.

He also pointed to the lack of access to fresh fruits and vegetables in low-income Black communities, areas often referred to as food deserts. He said that can contribute to obesity.

There are things you can’t change, including your age, race, and family history.

However, the Centers for Disease Control and Prevention (CDC) says you can help prevent stroke by making healthy lifestyle changes.

These include:

  • choosing a healthy diet
  • maintaining a healthy weight for your body
  • staying active
  • not smoking
  • limiting alcohol intake

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