Smoking and Stroke

 Smoking is a single biggest cause of premature death. The majority of deaths from smoking are due to lung cancer and other chest diseases such as bronchitis and emphysema, but heart disease and stroke contribute to this number.


How smoking causes stroke?

As well as nicotine, the chemical that makes tobacco so addictive, tobacco smoke contains of about 4000 toxic chemicals which are deposited in the lungs or absorbed in the blood stream.  Some of these damage the blood vessel walls, leading to atherosclerosis (narrowing of the arteries).  This increases the chance of the clot becoming lodged in an artery in the brain).

 Smoking also increases the stickiness of the special blood cells called platelets, which increases the risk of blood clots forming in major arteries to the brain and heart.  Smoking increases the risk of high blood pressure, which is one of the main risk factors of stroke.

 People who smoke are 2-3 times more likely to have a stroke than those who don't.  The more you smoke, the greater is your risk.  The danger starts quite young, in stroke terms; in men and women smokers under the age of 55, smoking seems to be a particularly prominent risk factor.

 Smoking is particularly dangerous for people who have high blood pressure.  They are five times more likely to have a stroke than smokers with normal blood pressure and twenty times more likely to have a stroke than non-smokers with normal blood pressure.

 Passive smoking-breathing in someone else smoke- may also be hazardous.  Recent research suggests passive smokers were nearly twice as likely to have a stroke as those who did not live or work in a smoky atmosphere.

 Ways to quit:

Because smoking is so damaging to health, more help is available to those who want to stop than never before.  A few people do manage to quit without any help but research has shown that as nicotine is so addictive, most people need support to stop smoking permanently.

 The nicotine replacement therapy (NRT): 

Nicotine replacement therapy replaces some of the nicotine you would normally get from cigarettes, helping to relieve withdrawal symptoms such as cravings, restlessness, irritability and depression.   You slowly reduce the dose over a period of time, until you do not use NRT at all.

 A wide range of NRT products are available in Botswana from your pharmacist without a prescription, including patches, gums, lozenges, nasal sprays, inhalers and tablets.  Products come in a range of doses and packs and you should expect continued treatment for up to three months.

 You can also get a range of nicotine replacement products on prescription throughout the country.  Discuss this with your doctor, who can determine the type of treatment that would be most suitable for you.

 The research has shown that the people who use NRT can double their chances of success in stopping smoking, especially if they also go to clinics for support from their health practitioner.


For many years now Zyban (bupripion), a non-nicotine smoking cessation aid has been available.   Unlike NRT it is not available without a prescription.  It is a tablet taken twice a day for about eight weeks.  It works on the neurotransmitters in the brain to reduce nicotine cravings and withdrawal reactions; it does not replace the nicotine normally consumed in cigarettes.  It is most suitable for those who are highly motivated to quit smoking.

 This drug is not suitable for everyone, particularly those with history of seizures or who may be taking certain medications.  Always tell your doctor about the medicines that you are taking- including the over-the-counter ones- and also mention any other health conditions or concerns that you might have.

 Other cessation aids:

A variety of herbal and other products are available, but there is little evidence to support their effectiveness.  Some people have found acupuncture or hypnotherapy helpful in giving up smoking.  If you decide to try this approach, be sure to go to a qualified practitioner.

Professor Kiran Bhagat, Cardiac Clinic


The Heart Foundation Botswana Website has a wealth of information on this topic and much more.