We’re Not Blowing Smoke! Tobacco Increases Dementia Risk.

Ask someone about the health risks of smoking and they will most likely cite lung cancer or asthma. Did you know smoking also increases the risk of dementia and cognitive impairment?

Tobacco smoking is the leading preventable cause of death in the world. To draw attention to the dangers of tobacco usage, in 1987, the World Health Organization (WHO) created World No Tobacco Day, observed annually on May 31st.

The statistics are distressing. Smoking kills about:

  • 500,000 people annually (includes secondhand smoke) in the United States
  • About 2 million people in China; and
  • About 160,000 in Japan

Globally, smoking takes more than 8 million lives annually (including secondhand smoke).

This year’s World No Tobacco Day empowers young people to engage in the fight against tobacco.

The Impact on Dementia

According to the WHO, smokers have a 45 percent higher risk of developing dementia than non-smokers, and 14 percent of Alzheimer’s cases globally are attributed to smoking (Alzheimer’s accounts for 60 to 80 percent of dementia cases). A cigarette a day increases one’s risk of cognitive decline.

More recently at the 2019 Alzheimer’s Association International Conference (AAIC) in Los Angeles, researchers reported that “heavy stable” smokers were 1.5 to 2.2 times more likely to have cognitive impairment compared to non-smokers. Cognitive impairment was observed among smokers as early as their 40s.

“Our findings demonstrate that early adult to mid-life smoking may be associated with cognitive impairment much earlier than we expected,” said Amber Bahorik, PhD, MSW, a postdoctoral researcher at the University of California, San Francisco. “This adds to the already dense body of evidence showing continued smoking negatively impacts several health functions and emphasizes the benefits of quitting.”

Why Do People Smoke?

To add to the long list of health risks, smoking also causes premature wrinkles, stained teeth, tooth loss, and ashtray breath. The consequences are dire and ugly, and yet, people still do it. Why?

The reasons are varied and range from habit to using it as a stress reliever to plain addiction. Many start smoking in their teenage years possibly due to peer pressure, echoing their parent’s habit, or as a form of rebellion. What can start out as a one-time activity can soon turn into addiction.

Nicotine* is a chemical found in all tobacco products and together with other chemicals found such as acetaldehyde, anabasine, nornicotine, anatabine, cotinine, and myosmine, causes that addiction. It takes less than 10 seconds of smoking for nicotine to reach and activate the receptors in the brain, making it a highly addictive habit and one that is difficult to stop. But it is possible to stub out that cigarette once and for all.

Why Quit?

In the midst of the gloomy statistics, there is positive news – smoking declined from 20.9 percent in 2005 to 13.7 percent in 2018 in the United States. In China, overall current smoking decreased from 28.1 percent in 2010 to 26.6 percent in 2018, and in Japan, it declined from 25.3 percent (2008) to 18.1 percent (2017).

One reason–among many­­–to quit? It lowers the risk of dementia and cognitive impairment. In 2018, results from a Korean study of men over 60 found that those who had never smoked had a 19 percent lower risk of dementia compared to continual smokers. For those who had given up smoking for more than four years, the risk dropped to 14 percent. And those who recently quit—four or less years without cigarettes—had a 13 percent lower risk.

Currently there is no cure or treatment for dementia. If there is an opportunity to lower the risk of dementia by living a healthy life and kicking the habit, why not take it? Research has shown that a third of dementia cases globally can be prevented by changing modifiable lifestyle factors which includes smoking.

Need more reasons to quit? Read some of the inspiring stories from former smokers who’ve given up smoking.

Resources to Help Quit Smoking

While quitting isn’t easy and can come accompanied by withdrawal symptoms, it is achievable. Smokers should talk to their healthcare provider about the safest and most effective way to stop tobacco smoking, and to obtain the support of friends and family in their efforts to kick the habit. Most insurance companies in the United States have programs to help smokers quit – contact them for more information.

Here’s a list of resources to help kick the habit.

  • Call 1-800-QUIT-NOW (1-800-784-8669). This is a free telephone support service to help people who want to stop smoking or using tobacco.
  • The I’m Ready to Quit! page links to many helpful resources.
  • gov. A website with tailored resources for women, veterans, teens, Spanish speakers, and people over 60 years old to help quit smoking.
  • WHO resources

Let World No Tobacco Day be a reminder to quit smoking and to make lifestyle changes to impact your cognitive health and overall wellbeing.

To measure your cognitive health such as attention, focus, and memory, click here. The cognitive test is clinically valid and can be taken remotely and on any mobile device.

Clinical Research

*Research has been mixed about the effects of nicotine on protecting the brain from Alzheimer’s. While some research has shown that nicotine–given independently without tobacco–can be protective, other research has shown to worsen it. Ursula Winzer-Serhan, PhD, an associate professor at the Texas A&M College of Medicine, who conducted the research that showed nicotine to be neuroprotective said, “Although the results are intriguing, we would need large-scale clinical trials before suggesting anyone change their behavior. At the end of the day, we haven’t proven that this addictive drug is safe — and it certainly isn’t during childhood or adolescence — or that the benefits outweigh the potential risks.”

A trial is currently ongoing with support from the National Institute on Aging and the Alzheimer’s Drug Discovery Foundation to more conclusively test the effects of transdermal nicotine patches for patients with mild cognitive impairment.

Are you a researcher who needs data for your clinical studies (virtual or not) or to recruit participants?

Or a company looking to measure the impact of a product on cognition?

Savonix can help.


Current Cigarette Smoking Among Adults in the United States (n.d.) Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm

Amber Bahorik, PhD, et al. Early Adult to Mid-Life Cigarette Smoking and Cognitive Function: Findings from the Cardia Study. (Funder: U.S. National Institutes of Health)

Why Do I Smoke and Why Do I Keep Smoking? (n.d.) American Thoracic Society. Retrieved from https://www.thoracic.org/patients/patient-resources/resources/why-do-i-smoke.pdf

Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., … & Cooper, C. (2017). Dementia prevention, intervention, and care. The Lancet, 390(10113), 2673-2734. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31363-6/fulltext#seccestitle70

Mons U, Schottker B, Muller H et al. (2013) History of lifetime smoking, smoking cessation and cognitive function in the elderly populationEuropean journal of epidemiology 28, 823-831.

Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol. 2011;10(9):819‐828. doi:10.1016/S1474-4422(11)70072-2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647614/