Smoking--the effects on cerebral vascular circulation. A variable in patient decision making.

Stroke, caused by either infartion or subarachnoid haemorrhage, can have devastating and debilitating effect on its victims. Traditional therapy has focused on the risk factors of hypertension, hyperlipidemia, atherosclerotic heart disease and diabetes milletus. More recently, the literature has focused on smoking and the short and long term effects of cerebral blood flow. The purpose of this paper will be to review the most recent research literature on both the chronic and acute effects of smoking on the cerebral vascular system. More specifically, there will be an examination of the effect of smoking on the outcome of a carotid endarterectomy, subarachnoid haemorrhage and the progression of atherosclerosis. Smoking is harmful and its cumulative effects, along with additive effects must be recognized. Despite increased risk, people continue to smoke affecting disease progression and treatment. Two models will be discussed--the health belief model and the health decision model. These models can provide a basis for nursing to develop and assess comprehensive smoking cessation programmes.