The Effects of Tobacco Smoke and Nicotine on Cognition and the Brain |
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Authors: | Gary E Swan Christina N Lessov-Schlaggar |
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Institution: | (1) Center for Health Sciences, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, USA |
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Abstract: | Tobacco smoke consists of thousands of compounds including nicotine. Many constituents have known toxicity to the brain, cardiovascular,
and pulmonary systems. Nicotine, on the other hand, by virtue of its short-term actions on the cholinergic system, has positive
effects on certain cognitive domains including working memory and executive function and may be, under certain conditions,
neuroprotective. In this paper, we review recent literature, laboratory and epidemiologic, that describes the components of
mainstream and sidestream tobacco smoke, including heavy metals and their toxicity, the effect of medicinal nicotine on the
brain, and studies of the relationship between smoking and (1) preclinical brain changes including silent brain infarcts;
white matter hyperintensities, and atrophy; (2) single measures of cognition; (3) cognitive decline over repeated measures;
and (4) dementia. In most studies, exposure to smoke is associated with increased risk for negative preclinical and cognitive
outcomes in younger people as well as in older adults. Potential mechanisms for smoke’s harmful effects include oxidative
stress, inflammation, and atherosclerotic processes. Recent evidence implicates medicinal nicotine as potentially harmful
to both neurodevelopment in children and to catalyzing processes underlying neuropathology in Alzheimer’s Disease. The reviewed
evidence suggests caution with the use of medicinal nicotine in pregnant mothers and older adults at risk for certain neurological
disease. Directions for future research in this area include the assessment of comorbidities (alcohol consumption, depression)
that could confound the association between smoking and neurocognitive outcomes, the use of more specific measures of smoking
behavior and cognition, the use of biomarkers to index exposure to smoke, and the assessment of cognition-related genotypes
to better understand the role of interactions between smoking/nicotine and variation in genotype in determining susceptibility
to the neurotoxic effects of smoking and the putative beneficial effects of medicinal nicotine. |
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Keywords: | Tobacco smoke Nicotine Brain Cognition Dementia |
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