THURSDAY, Aug. 14 (HealthDay News) -- The risk of stroke for a young woman smoker is directly related to the number of cigarettes she smokes, a new study finds.

While smoking has been clearly established as increasing the risk of stroke, "there is not a lot of data out there on the actual dose response," said Dr. John Cole, the study's corresponding author and an assistant professor of neurology at the University of Maryland School of Medicine in Baltimore.

Cole and his colleagues interviewed 466 women who had had a stroke, and also 604 women who hadn't. All were between the ages of 15 and 49, and were either smokers, non-smokers or former smokers.

Any smoking at all doubles the risk of stroke, the study found. The risk was 2.2 times greater for women smoking one to 10 cigarettes a day, 4.3 times greater for those smoking 21 to 39 cigarettes a day, and 9.1 times greater for those smoking two packs a day or more, compared to nonsmokers.

The study also demonstrated the benefit of quitting smoking. Stroke risk declined as early as 30 days after a woman gave up smoking and returned to normal in about two years.

"Stopping is the best thing to do, but cutting back will also reduce the risk," Cole said.

Smoking raises the risk not only of stroke but also of heart disease by damaging blood vessels and making blood clots more likely, Cole said.

The study findings are published in the Aug. 15 issue of the journal Stroke.

"Cigarettes, among other tobacco products, are the only products that when used as directed are still guaranteed to do harm," said Dr. David A. Meyerson, director of cardiology consultative services at Johns Hopkins University Bayview Medical Center, and a spokesman for the American Heart Association.

"There are four major reasons why," Meyerson added. "Smoking disrupts the cells lining the blood vessels. It increases blood fibrogen levels, which makes blood more likely to clot. It increases the stickiness of platelets, the cells that form blood clots, and it also decreases the body's natural clot-dissolving mechanism."

And young women who might be unconcerned about smoking's link to stroke should also know that it causes premature aging, Meyerson said.

The new study is valuable "because of its size and its ethnic diversity," he said. "We see broadly how it applies to all young women."

About 20 percent of young American women are smokers, the report noted.

Cole said a similar study on young men is planned.

Another report in the same issue of the journal dealt with stroke and another subject of interest to young women -- and men as well: fat around the waist. A study of 1,137 German adults found that measures of "abdominal adiposity" were strongly associated with the risk of stroke and transient ischemic attacks, which are momentary stoppages of blood flow to the brain.

Waist fat was a better indicator of stroke risk than body mass index, a standard measure of obesity, said the report from neurologists at Saxon Hospital Arnsdorf. Better diet and more exercise were recommended as corrective measures.

More information

Risk factors for stroke, including smoking, are described by the American Heart Association  .

WEDNESDAY, Aug. 13 (HealthDay News) -- More U.S. women are availing themselves of contraceptives services, such as birth control pill prescriptions, according to a new national survey.

From 1995 to 2002, the percentage of American women who said they received contraceptive services rose from 36 percent to 41 percent, according to Jennifer J. Frost, a senior research associate at the Guttmacher Institute in New York City, and author of the survey report published in the October issue of the American Journal of Public Health.

Overall, the percentage of women receiving all sexual and reproductive health care services --including not only birth control but also such services as STD testing and Pap tests -- remained constant at 74 percent, the survey found.

While the survey findings are encouraging, Frost said, "There's room for improvement."

She examined the 1995 and 2002 National Survey of Family Growth to detect patterns and trends in the use of sexual and reproductive health care services. The surveys involved in-home questionnaires of women ages 15 to 44 who were asked if they had received 13 specific services in the past 12 months.

While 76 percent of the respondents said they got services mostly from private health care providers, about one-fourth said they went to a public clinic or other public facility. And those who went to the publicly funded clinics got a broader range of services, according to the survey.

Behind the finding that women overall received more contraceptive services may be another trend, Frost said: That fewer women may be resorting to sterilization, so they need to return to the doctor for birth control pills and other contraceptive options.

The publicly funded clinics, she said, "are filling a big need for low-income women and providing a really important service."

"There are still a lot of women not getting all the services they need," Frost added, citing counseling or advice about contraception as an example.

Dr. Vanessa Cullins, vice president for medical affairs at Planned Parenthood Federation of America, said the survey's findings "highlight changes that hopefully will become trends."

Specifically, she was talking about the finding that most women received services from private doctors. "This suggests that private providers are beginning to focus on the contraceptive needs of women," she said.

Private health-care providers should take notes from public clinics, Cullins said. "Since the advent of Title X (a federal program established in 1970 under President Richard Nixon to fund family planning and preventive health services), publicly funded clinics have always focused on contraceptive access, pregnancy testing, and STD-related care."

More information

To learn more about contraception, visit the Planned Parenthood Federation of America Inc.  

TUESDAY, Aug. 12 (HealthDay News) -- The risk of relapse can linger for some breast cancer survivors even after completing five years of what doctors call systemic therapy, a new study found.

But, as gloomy as that news sounds, there is a relative bright spot: the risk may not be as dire as many women fear.

"I would like to think these numbers are smaller than women think they are," the study's lead author, Dr. Abenaa Brewster, a medical oncologist at the University of Texas M.D. Anderson Cancer Center in Houston, said.

Most women, she added, "remain terrified they are going to relapse. I think the message for women is, the risk may not be as large as they think."

Brewster's team evaluated 2,838 breast cancer patients whose disease ranged from stage I to III. All had been treated with some form of adjuvant systemic therapy between 1985 and 2001 and had remained disease-free for five years, which is traditionally considered a landmark in cancer survival.

The women had a variety of treatments -- surgery, chemotherapy, radiotherapy or endocrine therapy. Endocrine therapy involves tamoxifen, aromatase inhibitors and a combination of the drugs and is usually given for five years.

About 10 years after the diagnosis, 89 percent of the women remained recurrence-free. And about 80 percent remained recurrence-free 15 years after the diagnosis.

In all, 216 patients developed a recurrence, Brewster said. She found that the risk or recurrence varied by stage and tumor type. Those women with stage I disease had a 7 percent chance of relapse; stage II, 11 percent; and stage III, 13 percent.

Besides the stage of cancer at diagnosis, hormone receptor status affected risk, the study found. "Women who had ER-positive cancer were more likely to have late recurrences than those with ER-negative," Brewster said. This finding held true for premenopausal and postmenopausal women. While 34 ER-negative women had a relapse, 149 ER-positive did.

"Estrogen receptor status is a tumor marker we look at," Brewster said. "We know that those who have ER-positive tumors [have] cancers that are responsive to the effects of estrogen."

While women in the study were taking a variety of hormone therapies, none took five years of aromatase inhibitors, which are now the standard of care for postmenopausal women but weren't when the study began in 1985, Brewster said.

The study findings were published online Aug. 12 in the Journal of the National Cancer Institute.

Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, said the study findings leave some unanswered questions, such as the best course of action at the five-year mark. But it offers some interesting information, he added.

"The major message is that even though women may have gone through five years of hormonal therapy, they are still at risk of relapse," he said. Another important finding, he added, is that those women with ER-positive tumors seem to be at higher risk than those with ER-negative tumors.

"Basically the jury is out on the potential value of additional treatment strategies once the five years is completed," Lichtenfeld said. "Based on this study, we need to be open to question whether other treatment programs may be appropriate in some of these women after the five-year period is completed."

More information

To learn more about hormone therapy for breast cancer, visit the American Cancer Society  .

FRIDAY, Aug. 8 (HealthDay News) -- Breast-feeding offers a host of benefits to both mother and baby, including a stronger immune system for the baby and faster weight loss for mom. There are even some known psychological benefits from breast-feeding, such as a stronger parent-child bond.

But British researchers have recently discovered another mental bonus -- children who are breast-fed seem to cope with stress and anxiety more effectively when they reach school age.

In a group of almost 9,000 children between the ages of 5 and 10, children who weren't breast-fed and whose parents were getting divorced or separated were 9.4 times more likely to be highly anxious when compared to other children. But, children who were breast-fed as infants whose parents were getting divorced were only 2.2 times as likely to be highly anxious, the study found.

"Breast-feeding is associated with resilience against the psychosocial stress linked with parental divorce/separation," the study's authors concluded in a recent issue of the Archives of Diseases in Childhood.

The authors theorized that the physical contact between mother and child in the first few days of life could help form certain neural and hormonal pathways that affect a person's ability to cope with stress later in life.

Breast-feeding experts have long been aware of the mother-baby bond that occurs during breast-feeding. "There's a lot less verbal communication, but lots of tactile communication and eye contact that promotes positive physiological responses," said Liz Maseth, an outpatient lactation consultant at Akron's Children's Hospital in Ohio.

"Breast-feeding does seem to suppress stress responses in babies, and it does seem that there's a protective effect," she said.

"In terms of the biological possibility, breast milk is pretty amazing stuff, and the tactile interaction that goes along with breast-feeding does have an influence on the development of neurons," explained Judy Hopkinson, an associate professor of pediatrics in the section of nutrition at Baylor College of Medicine in Houston.

Hopkinson added that babies who aren't breast-fed may be able to reap similar benefits with lots of holding and touching.

The study authors also suggested that the bond created during breast-feeding might affect the way the child and the mother interact, and that effect might be long-lasting.

Hopkinson pointed out that mothers who are successful at breast-feeding often have a supportive social network, which could also help lessen a child's stress in times of crisis.

Whatever the reason for the association, it was clear that children who had been breast-fed were less stressed.

Both Maseth and Hopkinson said it's very important to try to begin breast-feeding as soon as possible after birth -- no more than one hour. Maseth said this is because the breasts contain glands that release the same scent as amniotic fluid, a scent that babies will recognize.

"For most mothers, breast-feeding doesn't come naturally. If the baby doesn't latch on, it can lead to feelings of failure and concern about whether or not the baby is getting enough milk. Women need lots of encouragement and education," Maseth said.

"Don't give up, though, seek help" she advised, adding that your baby's pediatrician will likely have information on what local breast-feeding resources are available.

"Breast-feeding is something for mothers and babies to enjoy. A time for them to cherish and nurture each other," said Hopkinson. For women who can't breast-feed, she said, that skin-to-skin contact between mother and baby can also help build a similar bond.

More information

The National Women's Health Information Center has more on breast-feeding.