THBD and Stroke: In addition to the effects of CS on the cellular elements of blood, smoking alters the protein levels of procoagulant and anticoagulation factors such as increased levels of fibrinogen; increased nitration of tyrosine residues on fibrinogen [29, 61], decreased thrombolysis [62] and decreased levels of thrombomodulin [36], thereby facilitating a prothrombotic state capable of inducing stroke or other hemorrhagic events.