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—In response to Dr Chin's question, our data do not indicate a protective effect of an earlier age at starting to smoke on the risk of subarachnoid hemorrhage (P for linear trend in age-adjusted relative risk across categories of age at starting equals.20 among current smokers and.10 among former smokers). The apparent association referred to by Dr Chin is thus easily compatible with random statistical fluctuation.Drs Gocze and Laszik raise the issue of passive smoking. To our knowledge, the association between passive smoking and risk of stroke has not been established in epidemiologic studies. Similarly, there are no data on the relationship between job stress and risk of stroke. However, this deserves further study, and our group is currently investigating the contribution of job stress to cardiovascular disease in this cohort of nurses.
Kawachi I, Colditz GA, Stampfer MJ, Willett WC, Speizer FE. Smoking Cessation and Risk of Stroke in Women-Reply. JAMA. 1993;269(17):2214. doi:10.1001/jama.1993.03500170043031
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