I hate smoking. I hate seeing other people smoke, especially young people.
Smoking kills.
The toxins contribute to heart disease and cancer and stroke.

It also affects our brains.

We all see the messages about why smoking is bad for us. Yet, despite many of us expressing a wish not to smoke, the choice of not smoking remains still too hard for many who prefer to carry on, despite the knowledge that yes they may have an increased risk of lung and throat cancer. And it is frustrating that you are continue to meet people who have lived to a ripe old age who have smoked several packets a day all their lives who will brightly tell you that it hasn’t done them any harm. There are always going to be those who dodge the bullet. But not everyone does.

Does the thought that smoking increases your risk of developing dementia make you think any harder about why it is a good idea to stop?

Heavy smoking in middle age increases the risk of Alzheimer’s disease and vascular dementia in men and women across different age groups. Their risk is doubled for developing a form of dementia within a twenty year period.
This was the finding of a study from Finland recently published in JAMA, Archives of Internal Medicine. They analysed the data from over 21000 multiethnic participants who took part in a survey conducted between 1978 and 1985 when aged between 50 to 60 years. Then from 1994 to 2008 when the average age of this cohort was 72 years, they tracked the number of diagnoses of dementia, Alzheimer’s disease and vascular dementia in the group.

Over the 23-year follow up of these 21,000 people, 25% were subsequently diagnosed with dementia. The heaviest smokers had the greatest risk.
Compared to non-smokers, those smokers who averaged two packs a day had a greater risk of dementia overall and also of the various forms of dementia. i.e. Alzheimer’s disease and vascular dementia.
Those who had given up smoking and those who smoked less than half a packet a day did not appear to be at increased risk.
There was a no difference in the rates by race or sex.

The relevance of this study is that smoking is a double-edged sword. Smoking has long been a well-recognised risk factor for stroke and contributer to vascular dementia. Now it appears that smoking by its contribution to oxidative stress and inflammation, is of significance in the development of Alzheimer’s disease. Smoking through vascular and neurodegenerative pathways can contribute to different forms of dementia.

This is the first study to evaluate the amount of long-term smoking on long-term risk of dementia in all of its forms.
As the world braces itself for the rising tide of dementia from ageing alone, the detrimental effect of smoking is going to become even more relevant.

Convinced yet?

Minna Rusanen; Miia Kivipelto; Charles P. Quesenberry, Jr; Jufen Zhou; Rachel A. Whitmer. Heavy Smoking in Midlife and Long-term Risk of Alzheimer Disease and Vascular Dementia. Archives of Internal Medicine, 2010; DOI: 10.1001/archinternmed.2010.393

In my last blog post I talked about the effect that smoking in general has on our memories.

Now it’s time to move on to the impact that passive smoking has on our brains, and those of our children.
And to look at the effect smoking has on those young adolescents and adults who actually take up smoking themselves.

Passive Smoking, Diabetes and Dementia risk

Passive smoking is associated with an increased risk for developing impaired glucose intolerance, a precursor for diabetes, which is itself, a risk factor for dementia.

A US study on 4500 subjects over a 15 year period, gave the following results in percentages those who developed impaired glucose tolerance.

22% of the smokers
17% of the passive smokers (ie living with a smoker)
14% of ex smokers
12% of non-smokers

In other words, the passive smoking group had a higher risk of developing impaired glucose tolerance even compared to the ex smokers.

And smokers themselves had almost twice the risk of non-smokers.

Another valid reason to give up the smokes.

We are witnessing an explosion in the number of people with obesity and diabetes, both major risk factors for impaired cognitive performance and dementia.

Why add to that risk by continuing to smoke?

Passive smoking, dementia and reduced academic performance.

Passive smoking;

• can lead to cancer in non-smokers.
• can lead to the development of heart disease in non-smokers.
• can lead to an increased risk of impaired glucose metabolism, a precursor for diabetes in non-smokers.

Heart disease and diabetes are associated with increased risk of dementia.

In the BMJ (British Medical Journal) of February 2009 it was stated that “second hand smoke (ie passive smoking) increases a person’s risk of dementia and other forms of cognitive impairment and also is associated with poorer cognitive performance in children and adolescents”

Good grief. If ever there was an incentive to give up smoking for the sake of your kids, surely this has to a big one!

The message is stark.

Passive smoking is linked to increasing your risk of dementia.

It also reduces academic performance in younger children and adolescents.

Dr. Mark Eisner for the University of California agreed in his statement that the evidence is emerging: parental smoking may impair a child’s cognitive development.

Prolonged exposure to passive smoking can lead to cardiovascular disease, increased risk of stroke and cognitive decline.

If I am repeating the message, it is because I think it is crucial to understand this.

Still in the US, a study by Leslie Jacobsen at Yale showed that adolescents who smoke showed inaccuracies and impairments of their working memory.

It was even suggested that teenagers who smoke are perhaps going to need additional educational support because of this.

Plus, it was the boys (who tend to start smoking earlier than girls) who were found to be most impaired in tests of selective and divided attention.

This was highlighted further by a study just published, by Prof Weiser of the Tel Aviv University Dept of Psychiatry and Sheba Medical Centre at Tel Hashomer Hospital.

The study looked at 20,000 young men enlisted in the Israeli army who were all healthy young adults aged between 18 and 21 years.

Around 28% smoked one or more cigarettes a day, 3% were ex smokers and 68% non-smokers.

They found that the average IQ for the non-smokers was 101
The average for the smoking group was 94
For those who smoked a packet or more a day they scored even lower at 90.

In an average population of healthy young men an IQ score would be expected to be between 84 and 116.

In his group socio-economic background was not a factor. These were all healthy young adults from a variety of backgrounds.

Plus, they were able to show that in twin brothers where one was a smoker and the other was not, the non-smoking twin on average registered a higher IQ

If we don’t want our kids to be dumbed down, then we seriously need to encourage them not to take up smoking in the first place as well as seeking to minimise any potential exposure to passive smoking.

As parents we all want the best for our kids and to see them grow and succeed in life.
Why would we knowingly diminish their ability to do well academically by either smoking ourselves or allowing them to smoke as teenagers?

If you are an adult who smokes, giving up will not only benefit your health, it will also benefit the health of your family in terms of protecting their brain.

Remember passive smoking is as deadly as smoking itself.

Yet another valid reason to give up the smokes.

Yul Brynner the actor, left us a number of years ago in 1985.
He died from lung cancer.

His message was clear and still as relevant as ever.

“Just don’t smoke.”

What action are you going to take to protect yourself and your family?

What decision are you going to take right now and commit to, in order to protect your brain health and that of your children in relation to smoking and passive smoking?

How can you keep your kids safe and discourage them from taking up smoking?

Just don’t smoke and keep your brain and your kids brains protected from passive smoking.

OK, hands up!
Which one of you didn’t know that smoking is bad for your health and is associated with an increased risk of heart disease, stroke and cancer?

Apart from the remote tribes people such as those living in the Envira region of the Brazilian/Peruvian rainforest, most people are aware of the negative effects cigarettes have on your health.

But did you know about the damaging effect smoking actually has on your brain?
And did you know about the damaging effect of smoking on your kids’ brains that are subjected to second hand smoke?

Do I have your attention?

Let’s start with the evidence available which tells us that

• smokers have poorer memories
• reduced problem solving skills
• and an increased risk of dementia.

In the 10 seconds it takes for the nicotine and other chemicals to reach your brain after the first drag on the cigarette, changes occur in your brain affecting your mood, your well-being and memory.
The effects of that cigarette will last for about 20 to 40 minutes in your body.

Thought that smoking makes you more alert?
Think again. A US study by the University of Michigan has shown that smokers have a slower and less accurate thinking ability.

Long term smoking damages your memory, your ability to problem solve and reduces your IQ.

Ouch!

Why is it so hard to quit smoking?

In the brain, we have a neurotransmitter called acetylcholine that is associated with a number of the body’s functions including learning and memory. It also facilitates other neurotransmitters that are associated with mood, memory and appetite. The nicotine attaches to the acetylcholine receptors in the brain mimicking its actions and promotes dopamine levels. Dopamine is associated with pleasurable feelings.
Ever wondered why some people say they enjoy smoking? Could be the raised dopamine levels talking.
Plus the elevated dopamine is the partial answer to why it is so hard to stop smoking, as the nicotine addiction wants you to keep those nice dopamine levels up.

If you smoke, you will score lower on memory tests. Period.

Smoking more than a packet a day will lead to increased difficulty remembering names and faces.

And remembering names is one of the most commonly voiced concerns about memory loss.

Smoking more than a packet a day provides you with a regular cocktail of toxins including toluene (also found in paint thinners and solvents and we know what that does for your brain), which can cause confusion and memory loss.

Ladies.
Those of you who smoke into middle age and menopause need to be aware that nicotine will lower your blood oestrogen levels and may inhibit the effect oestrogen has on your brain, exacerbating any brain cell effects of the fluctuating oestrogen levels.

Women who smoke will score 20% lower in tests of executive thinking ie reasoning, planning and organising.

So what is the evidence supporting smoking affects memory?

Dr Marcus Richards at University College London did a study on 5362 people born in 1946 and divided them into groups as either smokers, non-smokers and ex smokers.

They were given a list of 15 words for 2 seconds each and were then asked to write sown as many as they could remember,
In the second part of the test they were shown a page of letters and they were given one minute to find and remove all of the “P’s” and “W’s”

The results showed the smokers had the lowest scores for memory.

Those who had given up smoking, had a lower level of decline than those who had continued to smoke. So if you do smoke you will still be doing your brain a huge favour by stopping.

The relationship between memory and smoking was most marked in those who smoked 20 a day plus. In other words, the more you smoke the worse the effect on your memory.

Smoking can therefore be seen as accelerating age related memory problems.

Is this surprising?
Well, impaired memory is not uncommon in smoking related illnesses including cancer, heart disease, stroke, bronchitis, emphysema and asthma.

Why smoking has this effect remains unclear but it is thought that it could be because smoking increases a person’s risk of developing high blood pressure (itself a risk factor for dementia). it has also been found that tobacco contains a substance called NNK which can cause neuroinflammation. It is this inflammation that may lead to neurodegenerative disorders.

Or it may be that smoking has an effect on the supply of oxygen on the brain.

Or it could be a direct toxic effect of the multitude of other toxins found in cigarette smoke.

Whatever the underlying reason, it is clear that smoking affects memory and is an increased risk for dementia.

Hint, this is a really good reason to give up the smokes.
It would be a really good idea to stop now.

The benefit of stopping is that there is less memory deficit the earlier you quit.

And it’s never too late to stop.

I look forward to hearing your comments. But no excuses about how hard it is to give up smoking. I’ve heard them all.

If you smoke you have an addiction (as well as a shrinking brain) so it takes a decision, commitment and perseverance to quit.

You can do it.

In Part Two of this blog on smoking Jenny will be covering the worrying evidence of the effects of passive smoking on our kids and the effects on kids brains if they themselves smoke.

Stay tuned.

Ref: American Academy of Neurology (2007, September 6). Smokers Are More Likely To Develop Dementia.