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Association of Tobacco Cessation With Cognitive Decline: A Multi-State Analysis
Mansi Joshi1, Siya Patel1, Danielle Fastring2
1College of Medicine, William Carey University College of Osteopathic Medicine, Hattiesburg, USA.
Cureus
|June 15, 2026
Summary
Individuals who quit smoking 10 or more years ago have higher odds of cognitive decline. Smoking cessation duration is linked to cognitive decline, with shorter cessation periods showing greater risk.
Area of Science:
- Neuroscience
- Public Health
Background:
- Smoking is linked to cognitive decline and reduced entorhinal cortex volume.
- Early screening of high-risk individuals may slow cognitive decline progression.
Purpose of the Study:
- To investigate the association between tobacco cessation duration and cognitive decline in the US.
- Adjusting for age, race, sex, education, and income using population-level data.
Main Methods:
- Utilized data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS) Cognitive Decline Module.
- Excluded participants under 45; analyzed data from specific states.
- Employed bivariate and multivariable logistic regression, adjusting for demographic factors.
Main Results:
- A significant association was found between smoking cessation duration and cognitive decline.
- Individuals who quit smoking 10+ years prior had 3.648 times higher odds of cognitive decline compared to never-smokers.
- Higher odds of cognitive decline were observed with shorter durations since smoking cessation, peaking between 1 month and 3 months post-cessation.
Conclusions:
- Never-smokers or those quitting 10+ years ago are less likely to experience cognitive decline.
- Self-reported data is a limitation; smoking cessation may reverse or halt cognitive effects.
- Early intervention including smoking cessation counseling is recommended to mitigate cognitive decline.
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