PURPOSE:Although stroke survivors who continue smoking face increased risk for subsequent strokes, little is known about U.S. poststroke smoking patterns. We examined smoking prevalence in U.S. stroke survivors and what sociodemographic factors are associated with continuation of smoking in these individuals. METHODS:We determined the prevalence of smoking in U.S. stroke survivors (n = 56,523) using 2016-2018 Behavioral Risk Factor Surveillance System data. A logistic regression was created to identify associations between sociodemographic factors and poststroke smoking continuation. RESULTS:20.4% of stroke survivors continued to smoke after their stroke (14.7% smokes every day, 5.7% smokes some days). Older age, being male (OR: 1.15, 95% CI: 1.05-1.27), Asian (OR: 2.79, 95% CI: 1.52-5.11) or Hispanic (OR: 1.31, 95% CI: 1.06-1.63) ethnicity, higher income, higher educational attainment, and access to health care (OR: 1.27, 95% CI: 1.02-1.59) and a personal doctor (one doctor OR: 1.51, 95% CI: 1.25-1.83; more than one doctor OR: 1.59, 95% CI: 1.27-1.99) corresponded with increased odds of smoking continuation after a stroke. CONCLUSIONS:A greater push for smoking cessation by clinicians and support programs to aid with cessation in U.S. stroke survivors is needed to decrease the high prevalence of poststroke smoking in this population.