Is Your Brain Going Up in Smoke?

Smoking shrinks the brain. It also increases risk for stroke, cognitive decline and dementia, accelerates brain aging, and more.

For the 3.5 million Americans over the age of 65 who smoke, here is yet another reason to stub out that cigarette: Researchers have discovered that smoking shrinks your brain!

A comparison of brain scans of smokers with those of non-smokers revealed that the tobacco habit causes atrophy in the brain’s cortex, according to a report published online Feb. 10, 2015 in the journal Molecular Psychiatry. The cortex is responsible for critical cognitive functions such as perception, language, and memory, and thinning of this brain region is a biomarker of cognitive decline. Quitting smoking can reverse the process, the researchers found.

“Regular smoking has many deleterious effects on the brain, and this study offers yet more proof of the harm it can cause,” says Maurizio Fava, MD, Executive Vice Chair of the Department of Psychiatry and Director of the Clinical Research Program at MGH. “On the other hand, we know that quitting smoking is strongly associated with improvements in brain health and functioning—and that’s a powerful argument for giving up the habit, no matter what your age is.”

WHAT YOU CAN DO

If you or a loved one finds it difficult to quit smoking without help, consider taking advantage of these resources:

  • Your health care provider, who can support your efforts to quit by providing advice, suggesting medications to ease withdrawal symptoms, and offering referrals for counseling.
  • Counseling programs Ask your doctor to refer you to a mental health professional or program focused on helping individuals or groups overcome dependency on smoking.
  • A 12-step program Groups such as Nicotine Anonymous and Smokers Anonymous offer the ongoing support of others who have struggled with dependency on tobacco.
  • Inpatient programs Your doctor also may be able to recommend an inpatient program that offers intensive counseling. Many of these have an impressive record of success with people dependent on cigarettes.

Getting Help

“The good news is that there are a number of products and services available that can help people overcome their addiction to smoking,” says Dr. Fava. “Older age and longer duration of smoking don’t seem to make quitting more difficult. In fact, some research suggests that smokers 65 years of age and older have a better chance of staying smoke-free permanently than younger adults who try to stop smoking.”

If you or a loved one want to quit smoking, there are a number of options to choose from:

  • The patch supplies gradually tapering doses of nicotine that are absorbed through the skin to ease the effects of smoking cessation.
  • Nicotine gums, nasal sprays or inhalants: Used at will, these supply small doses of nicotine to ease cravings and alleviate the discomfort of withdrawal.
  • Zyban® (bupropion): This prescription medication is an antidepressant that reduces cravings and alleviates most withdrawal symptoms. It has approximately a 30 percent three-month success rate in helping smokers who want to quit.
  • Chantix® (varenicline tartrate): These prescription tablets contain a substance that acts on sites in the brain affected by nicotine, easing withdrawal symptoms while blocking the effects of nicotine so that resumption of smoking is discouraged. It works approximately 44 percent of the time at three months and can cause adverse side effects.
  • Federal government resources: SmokeFree.gov provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.
  • LiveHelp, an instant messaging service associated with the National Cancer Institute designed to help with smoking cessation.
  • The National Institutes of Health web site: MedLinePlus.gov also offers helpful information. Click on “Health Topics,” and then look under “smoking cessation.”
  • Telephone help lines, such as the National Cancer Institute’s telephone quitline at 1-877-44U-QUIT, or local and state telephone quitlines, at 1-800-QUIT-NOW
  • SmokefreeTXT, the National Cancer Institute’s text messaging service that promotes smoking cessation.

“Electronic cigarettes, which supply nicotine without the chemical additives found in cigarettes, are not regulated and have not yet been shown to be effective in helping smokers to quit,” Dr. Fava cautions.

“Until research supports the use of these devices to help with smoking cessation, it is advisable to use other cessation methods that have been proven safe and effective.”

Serious Reasons to Quit

If the prospect of brain shrinkage isn’t sufficient motivation to quit cigarettes, perhaps learning about some of the other brain-killing effects of smoking will convince you or a loved one. According to the American Lung Association, cigarette smoke contains more than 7,000 chemicals, many of which are poisonous. The actions of these chemicals on the brain have been linked to serious consequences, such as:

  • Accelerated decline in critical thinking and memory, with higher cigarette consumption linked to greater decline
  • Brain-damaging neuroinflamation promoted by the tobacco compound NNK provokes immune cells in the central nervous system to attack healthy cells, leading to serious neurological damage
  • Increased cell death and diminished neurogenesis (creation of new cells) in the hippocampus, the brain’s memory center
  • Increased risk for Alzheimer’s disease, vascular dementia, and any dementia
  • 70 percent increased susceptibility to depression and anxiety
  • Double the risk of dying from a stroke
  • More rapid brain aging
  • Damage to neurons and cell membranes
  • Greater risk for high blood pressure
  • Heightened risk for blood clots
  • Negative changes in both “good” and “bad” cholesterol levels, leading to greater likelihood of clogged blood vessels
  • Higher risk for brain aneurysms, especially larger aneurysms that are more likely to rupture and lead to death or disability.
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