In “Smoking cessation and outcome after ischemic stroke or TIA,” authors Epstein et al. assessed whether smoking cessation after an ischemic stroke or TIA improves outcomes. Following a prospective observational cohort study of 3,876 nondiabetic men and women enrolled in the Insulin Resistance Intervention After Stroke trial, they found that cessation of cigarette smoking after an ischemic stroke or TIA was associated with significant health benefits over 4.8 years. Commenting on the study, Dr. Munakomi points out that the health hazards of passive smoking may have been neglected in the study. He explains that environmental tobacco smoke and secondhand smoking increase the risk of stroke and suggests implementing strict heath regulation acts to address this issue.