title: Risk factors for continued cigarette use after subarachnoid hemorrhage.
abstract: OBJECTIVE
  Cigarette smoking is a risk factor for the formation and rupture of intracranial aneurysms. Few studies have examined predictors of resumption of cigarette smoking after a first episode of subarachnoid hemorrhage (SAH).
  
  
  METHODS
  Of 620 SAH patients treated between July 1996 and November 2002, we prospectively evaluated continued cigarette use in 152 smokers alive at 3 months. Univariate and multivariate logistic regression analyses were used to identify potential demographic, social, and clinical predictors of continued cigarette use, defined as smoking > or =1 cigarette per week in the month before follow-up.
  
  
  RESULTS
  Thirty-seven percent (56 of 152) resumed smoking after their SAH. Patients who continued smoking were younger, were more often black, had begun smoking at an earlier age, and had a higher frequency of prior alcohol or cocaine use and self-reported depression or anxiety than those who quit (all P<0.05). Smoking at < or =16 years of age (odds ratio [OR], 5.88; 95% confidence interval [CI], 2.33 to 14.29), self-reported depression (OR, 5.29; 95% CI, 2.10 to 13.35), and prior alcohol use (OR, 4.51; 95% CI, 1.45 to 14.05) independently predicted continued cigarette use. Smokers had a functional outcome similar to that of nonsmokers at 3 months but were more likely to resume alcohol consumption (OR, 3.88; 95% CI, 1.91 to 7.88).
  
  
  CONCLUSIONS
  More than one third of prior smokers continue to use nicotine after SAH. Young age at smoking onset and a history of depression or alcohol use are risk factors for continued cigarette use. Targeted smoking cessation programs are needed to reduce the high rate of smoking resumption after SAH.
authors.affiliation: Division of Critical Care Neurology, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA. sam14@columbia.edu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ballard
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Kreiter
authors.forename: Jan
authors.initials: J
authors.lastname: Claassen
authors.forename: Robert G
authors.initials: RG
authors.lastname: Kowalski
authors.forename: E Sander
authors.initials: ES
authors.lastname: Connolly
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Mayer
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D016017:Odds Ratio; D044469:Racial Groups; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology*