With nonsmokers as the reference, adjusted HRs for stroke recurrence were 1.93 (95% CI, 1.43 2.61) in persistent smokers, stroke, and 1.16 (95% CI, 0.75 1.79) in for- mer smokers, delineating the effects in smok- ers, former smokers and quitters. HRs for stroke recurrence ranged from 1.68 (95% CI, 1.14 2.48) in those who smoked 1 to 20 cig- arettes daily to 2.72 (95% CI, 1.36 5.43) for those who smoked >40 cigarettes daily.143 The Cardiovascular Health Study (N=546) similarly identifies a substantially increased risk of stroke recurrence in elderly smokers at a median A longitudinal study in Han Chinese individuals with ischemic stroke (N=421) iden- tified an adjusted HR for smokers at 1 year of The SMART study (Second Manifestations of Arterial Disease; N=4673) identified that smoking cessation increases life expectancy (average 5 years) and recurrent major atherosclerotic cardiovascular events occur 10 years later compared with per- 3. Primary prevention data highlight the risk of exposure to environmental tobacco smoke, also called passive smoking or secondhand smoke, on stroke rates in nonsmokers. 