One-in-ten cigarette smokers suffer cognitive decline by age 45

One-in-ten cigarette smokers in their 40s suffer cognitive decline – but quitting can reverse the damage, study finds

  • Smoking cigarettes can cause a person to suffer cognitive issues in their 40s
  • Quitting smoking for more than a decade can cut the risk in half, though
  • Smoking has long been linked to Alzheimer’s in patients over the age of 65 

Smoking cigarettes can cause a person to suffer cognitive decline in their 40s, a study finds.

A study of 136,018 participants over the age of 45 by a team at Ohio State University (OSU) found that 10 percent of smokers middle-aged or older suffered from memory loss and confusion. Overall, smokers were twice as likely to experience brain problems than their peers.

Kicking the bad habit can stop the decline. Former smokers who stopped smoking more than ten years ago were at a 50 percent increased risk of brain issues – half that of current smokers.

Cognitive issues are rare in people in their middle-ages, as the brain does not start losing function until after age 65 in most cases. Smoking has been linked to many significant health issues later in life, though, such as Alzheimer’s and cancer among others. Women are also more likely to suffer cognitive decline than men.

Researchers found that smoking can caused people to suffer cognitive decline as early as 45 years old (file photo)

Smoking has long been linked to an increased risk of developing cognitive conditions like Alzheimer’s, but presentation of these issues in middle-aged people is rare.

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For their research, published in the Journal of Alzheimer’s Disease, researchers surveyed the sample of nearly 140,000 on their smoking habits, and whether they feel they have suffered memory loss during that period.

They found that eight percent of people who had never smoked in their lives experienced cognitive decline.

Meanwhile, 16 percent of current smokers reported suffering from brain issues and memory loss.

Many of these smokers were of an age considered to be too young to deal with these problems.

Just under 10 percent of participants aged 45 to 49 reported brain issues when surveyed – with researchers noting that these were almost all among smokers.

The rate of cognitive issues reported was similar among survey participants in their fifties.

Differences in cognitive decline between smokers and non-smokers had largely diminished in older age, though, as at that point many people develop conditions like Alzheimer’s and dementia for a variety of reasons. 

What is Alzheimer’s?

Alzheimer’s disease is a progressive, degenerative disease of the brain, in which build-up of abnormal proteins causes nerve cells to die.

This disrupts the transmitters that carry messages, and causes the brain to shrink. 

More than 5 million people suffer from the disease in the US, where it is the 6th leading cause of death, and more than 1 million Britons have it.


As brain cells die, the functions they provide are lost. 

That includes memory, orientation and the ability to think and reason. 

The progress of the disease is slow and gradual. 

On average, patients live five to seven years after diagnosis, but some may live for ten to 15 years.


  • Loss of short-term memory
  • Disorientation
  • Behavioral changes
  • Mood swings
  • Difficulties dealing with money or making a phone call 


  • Severe memory loss, forgetting close family members, familiar objects or places
  • Becoming anxious and frustrated over inability to make sense of the world, leading to aggressive behavior 
  • Eventually lose ability to walk
  • May have problems eating 
  • The majority will eventually need 24-hour care   

 Source: Alzheimer’s Association


‘The association we saw was most significant in the 45-59 age group, suggesting that quitting at that stage of life may have a benefit for cognitive health,’ Dr Jeffrey Wing, senior author of the study and epidemiology professor at OSU.

Quitting smoking can undo some of the damage, though. Around 12 percent of survey participants that had quit more than a decade ago reported cognitive issues.

This is still a 50 percent increase from the baseline group of non-smokers, a significant decrease compare to non-smokers.

People who had quit within the last ten years had a 13 percent risk of developing the condition, slightly higher than the long-time quitters. 

‘These findings could imply that the time since smoking cessation does matter, and may be linked to cognitive outcomes,’ Jenna Rajczyk, a doctoral student at OSU who led the research, said.

‘This is a simple assessment that could be easily done routinely, and at younger ages than we typically start to see cognitive declines that rise to the level of a diagnosis of Alzheimer’s Disease or dementia,’ she continued. 

‘It’s not an intensive battery of questions. It’s more a personal reflection of your cognitive status to determine if you’re feeling like you’re not as sharp as you once were.’  

The study only took self-reported examples of cognitive issues, and did not gather any data on clinical Alzheimer’s or dementia diagnosis.

Signs of the devastating condition often start to emerge decades before the patient is in a position to receive a diagnosis, and it is rare for a middle-aged person to be told by a doctor they have the condition.

Alzheimer’s is the leading cause of dementia in the US. It affects around 6.5million Americans aged 65 and older.

The number of Americans suffering the condition is expected to double over the next 20 years, as longer life-spans will lead to more cases over time.

There is no known cure for the condition, and treatments available to slow down the progression of the disease are sparse. 

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