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Dr. Munakomi's comment on my editorial1 brings up a great point: in addition to the risk of stroke due to smoking, secondary and tertiary smoke exposure also increases the risk of stroke. In order to cultivate smoke-free environments, individual smoking cessation is needed in addition to the policies used to create smoke-free environments. While smoke-free policies create public smoke-free environments, they do not address the individual environments within the confines of private environments. If individual cessation is not addressed, people can continue to create private smoking environments where the risk of stroke is increased for not only the people who are smoking, but also others with access to the private environment. Without addressing individual smoking cessation, policies that only address public spaces will not be as effective. In order to be most effective at reducing stroke risk due to the effects of smoking, effective approaches would need to entail both individual smoking cessation programs as well as policy changes to facilitate public and private smoke-free environments.
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