Contributing factors which led to relapse of tobacco-seeking behaviour among stroke survivors, in a selected tertiary care hospital, New Delhi

Abstract

Background: The outcome of treatment of stroke depends on removal of modifiable risk factors, such as stopping tobacco seeking behavior which is important factor to prevent reoccurrence of stroke. Aim: To identify contributory factors and relapse of tobacco seeking behavior among tobacco users recovering from stroke. Methodology: An exploratory, cross sectional study on 164 tobacco user post-stroke patients seeking treatment from AIIMS, New Delhi, India. Tools: A demographic data sheet, Pattern of Tobacco Use semi-structured proforma, MFTS, MF-ST Version scale, Checklist to assess factors contributing relapse of tobacco seeking behavior and NIHS scale were used for the study. Results: Mean age of post-stroke patients was 50.56±1.27 years. Slightly less than half (45%) of the patients relapsed to tobacco use post-stroke attack after initial abstinence whereas 54.87% (n=90) of the patients did not relapse to tobacco use. Most of the subjects gave some reasons of relapse like craving or uncontrollable desire. A little over one third of the patients reported symptoms such as irritability, sadness, poor concentration, constipation and non availability of tobacco cessation treatment which they reported led to their relapse of tobacco use. Most of the subjects reported that they were still not ready for enrolling in Tobacco Cessation treatment Programme (60.3%). A significant difference was found between relapse of tobacco seeking behavior with MF-ST (smokeless) scale (p< 0.001) than MF-TS (smoking) scale (p< 0.05). Conclusion: The prevalence of tobacco users getting attack of stroke is four times higher than non-tobacco users. Even though patients are warned by doctor to stop smoking, they continue to use tobacco and to be under risk of reoccurrence of stroke and other complications.