Does smoking cause dementia?

Smoking is dangerous at any age. In older people the body is less able to bounce back from the damage it causes, particularly if it’s been a decades-long habit.

Rates of regular smokers continuing to fall. However, hospital admissions caused by smoking, including respiratory, circulatory and digestive system diseases and cancer, are steadily rising.

While smoking rates among older people are significantly lower than younger people, (unfortunately likely relevant to the mortality rate of smoking) the long-term health consequences of smoking often catch up with people as they age.

The long-term effects of smoking are many and well known. These include 12 different types of cancer, heart disease, stroke and more. There also are lesser-known effects on smokers’ cognitive abilities.

Cognitive effects of smoking include:

• Accelerated cognitive decline in old age
• Reduced attention span
• Slower information processing
• Negative effects on mental health, including increased stress and anxiety. Smoking can provide immediate and short-lived relief from these but ultimately make them worse.

Can smoking cause dementia?

Smoking is associated with an increased risk of dementia. It is one of the preventable lifestyle factors that can contribute to a person developing dementia. One study even concluded that heavy smoking in mid-life raises the risk of dementia 100%.

Smoking is a particular risk factor for vascular dementia. Vascular dementia is caused by limited blood flow to the brain. Smoking constricts blood vessels that carry essential nutrients and oxygen to the brain. Additionally, and for similar reasons, smoking increases your chance of having a stroke. This in turn can lead to vascular dementia.

Smoking is also found to put oxidative stress on the brain. This is linked to the development of dementia, particularly Alzheimer’s disease. The damage from this can be curtailed by quitting smoking and eating an abundance of fruits and vegetables that are high in antioxidants.

The curious relationship between nicotine and inflammation

While the chemicals that are involved in tobacco smoking and electronic cigarette vaping are harmful to mind and body, there is evidence that nicotine itself can actually be protective against dementia.

Tobacco smoking and vaping both cause inflammation in the body. Conversely, nicotine in itself has been shown in some studies to reduce inflammation in the brain and offer some protection against some types of dementia, particularly Parkinson’s disease.

The negative effects of smoking or vaping this nicotine do outweigh the potential positive effects of nicotine itself.

Does vaping have any link with dementia?

It’s far too early for any definitive evidence on whether there is a direct link between vaping and dementia. That said, there is evidence that it may be bad for the brain.

Electronic cigarettes have been available for purchase in the UK since 2005. They really began to steamroll in popularity in the mid-2010s.

They were marketed as a safe alternative to smoking and an effective means to quit. Concerns have been brewing around the safety of vaping for some years.

E-cigarettes are undoubtedly safer than tobacco smoking. Public Health England reported in 2018 that they carry 0.5% of the cancer risk that tobacco smoking does. However, there hasn’t been enough time for much research into the long-term effects.

E-cigarettes come without some of the side-effects of smoking, such as the smell, fire risk and yellow teeth. These factors can not only make vaping more attractive than smoking but easier to use more heavily. This can make people more heavily addicted than they ever were to tobacco.

Evidence is emerging about the effects of vaping on health in older people:

• Older lungs cannot recover from the chemicals carried in vapes as well as younger lungs.
• Vaping has been found to negatively affect memory, impulse control and critical thinking, as well as negatively affect mental health.

How can I help a loved one with dementia to quit smoking?

Despite older bodies being less able to recover from the long-term effects of smoking, doing so is still worthwhile, at very least for the improvements in physical and mental health.

If your loved one is living with dementia and smokes, it’s important to note that they have every right to do so if they choose to. Even if they have been assessed as lacking the mental capacity to make decisions and you have a Health and Welfare Lasting Power of Attorney (LPA), you still can’t force them to stop smoking. Care homes can also support people who wish to continue to smoke.

You can help them to continue to smoke in a safer way, such as introducing them to e-cigarettes as an alternative to tobacco and supporting them to get liquids/vape pens and show them how to charge it.

If they are keen to stop, however, you can support them to do so. Their dementia may present extra challenges with this, particularly in forgetting that they are trying to quit.

How you support them to quit is highly individual, but some suggestions include:

• Supporting them to buy nicotine patches, gum or lozenges
• Creating visual reminders that they are quitting
• Sourcing or printing leaflets about what withdrawal symptoms they can expect
• Supporting them through withdrawal, such as administering painkillers safely or doing activities with them to take their mind off it
• Checking in regularly with how they’re doing and reminding them of why they wanted to quit

If your loved one denies they ever said they’d quit smoking, or changes their mind, it can be hard to know what is dementia affecting their memory and what is a true change of heart. Ultimately it is their choice so if they are adamant they want to smoke again and no reminders of their motives or gentle persuasion will change their mind, you have to respect their autonomy.