Smoking trajectories and risk of stroke until age of 50 years – The Northern Finland Birth Cohort 1966

Autoři: Ina Rissanen aff001;  Petteri Oura aff003;  Markus Paananen aff003;  Jouko Miettunen aff003;  Mirjam I. Geerlings aff004
Působiště autorů: Department of Neurology, Oulu University Hospital, Oulu, Finland aff001;  Department of Neurosurgery, Oulu University Hospital, Oulu, Finland aff002;  Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland aff003;  Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands aff004;  The Center For Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225909



Smoking is a well-known risk factor for stroke. However, the relationship between smoking trajectories during the life course and stroke is not known.


We aimed to study the association of smoking trajectories and smoked pack-years with risk of ischemic and haemorrhagic strokes in a population-based birth cohort followed up to 50 years of age.


Within the Northern Finland Birth Cohort 1966, 11,999 persons were followed from antenatal period to age 50 years. The smoking behaviour was assessed with postal questionnaires at ages 14, 31 and 46 years. Stroke diagnoses were collected from nationwide registers using unique study number linkage. The associations between smoking behaviour and stroke risk were estimated using Cox regression models.


Six different patterns in smoking habits throughout the life course were found in trajectory modelling. During 542,140 person-years of follow-up, 352 (2.9%) persons had a stroke. Continuous smoking during the life course was associated with increased stroke risk (HR = 1.69; 95% CI 1.10–2.60) after adjusting for sex, educational level, family history of strokes, leisure-time physical activity, body mass index, alcohol consumption, hypertension, hypercholesterolemia, and diabetes. Per every smoked pack-year the stroke risk increased 1.04-fold (95% CI 1.03–1.06). Other smoking trajectories were not significantly associated with stroke risk, nor were starting or ending age of smoking.


Accumulation of smoking history is associated with increased risk of stroke until age of 50 years. The increased stroke risk does not depend on the age at which smoking started. Given that the majority starts smoking at young age, primary prevention of strokes should focus on adolescent smoking.

Klíčová slova:

Alcohol consumption – Cohort studies – Hemorrhagic stroke – Ischemic stroke – Smoking habits – stroke


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2019 Číslo 12