Smoking Linked to Cognitive Decline

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Smokers appear to be at greater risk for mental decline than nonsmokers. Research has shown that current smokers over age 65 were 3.7 times more likely to experience mental decline over a one-year period than people who did not smoke or had smoked in the past. Similarly, in a study reported in the European Journal of Neurology, current smokers were nearly three times as likely to develop Alzheimer’s and twice as likely to develop vascular dementia as were people who had never smoked. Researchers believe that smoking may impair mental function by damaging blood vessels that supply nutrients to the brain. Research also suggests that quitting may reduce the risk.

Smoking is a difficult habit to break. In fact, only 4 to 7 percent of individuals successfully quit on their own, without any kind of aid or reinforcement. But several options can significantly increase your chances of quitting; these include nicotine replacement therapy, medication, and counseling. With counseling plus nicotine replacement or medication, this number rises to 25 to 33 percent.

Nicotine replacement therapy minimizes symptoms of nicotine withdrawal and helps control cravings. There are many forms—gums, skin patches, nasal sprays, inhalers, and lozenges. Some of these are sold over the counter; others must be prescribed by your physician. You should start taking nicotine replacement therapy on your quit date and continue taking it for a minimum of eight to 12 weeks.

Two prescription medications—bupropion (Zyban) and varenicline (Chantix)—also help reduce cravings and withdrawal symptoms by acting on nicotine receptors in the brain and disrupting the pleasurable feelings that smoking typically produces. Your doctor may recommend that you begin taking bupropion or varenicline a week or two before your intended quit date and that you keep taking the medication for two to three months. A word of caution: If you experience any serious unusual changes in mood or behavior or feel like hurting yourself or someone else while taking either drug, stop taking the medication and call your doctor right away.

When Zyban and Chantix aren’t helpful, doctors occasionally prescribe the antidepressant nortriptyline (Aventyl, Pamelor) or the blood pressure drug clonidine (Catapres).

Counseling—either in a group or one-on-one with a therapist— can be helpful as well. During counseling you learn coping skills, ways to prevent a relapse, and stress management. You also receive social support and encouragement.