AIM:The role of smoking as risk factor for stroke is controversial. An ecological design study was performed to test the association between stroke mortality and smoking in Brazil. Lung cancer mortality was used as a surrogate for smoking habit. METHODS: The mortality rate for stroke (ICD-9:430-438) and lung cancer (ICD-9: 162) were determined in the following metropolitan areas: Belém, Recife, Salvador, Belo Horizonte, Rio de Janeiro, São Paulo, Curitiba and Porto Alegre for males and females between 30 years-old and 69 years-old. ANOVA test was used to compare both age-adjusted mortality rates. RESULTS:A negative association by ANOVA was determined between age-adjusted rates and age-specific rates, except among males with 40-49 years-old. CONCLUSION: These results may be on account of three causes: the different smoking role as a risk factor in the distinct stroke subtypes analyzed; the competitive risk between coronary heart disease and stroke; and the high prevalence of arterial hypertension in the Brazilian metropolitan areas.
smoking; stroke; mortality; metropolitan regions; Brazil; 1988