Smoking and the brain

doi:10.1136/bmj.320.7242.1087

BMJ 2000;320:1087-1088 ( 22 April )

Editorials

Smoking and the brain

No good evidence exists that smoking protects against dementia

Papers p 1097

The first 150 words of the full text of this article appear below.

Smoking prevents dementia? Smoking causes dementia? Over the past decade a succession of research findings has produced apparentlyconflicting evidence on this question. In the early 1990s resultsfrom case-control and family studies suggested a protective effect. ¹ ² The findings were widely reported,³ including in the mass media,and some scientists stated publicly that they would consider takingup smoking if they had a family history ofdementia.

Tobacco companies began to sponsor conferences on dementia, perhaps because it seemed to offer them a lifeline in an otherwiserelentless sequence of findings about the deleterious effectsof smoking. If smoking reduced life expectancy and also reducedthe likelihood of survivors developing dementia then, from a policyperspective, there might be a role for the habit in laterlife.

The potential protective effects have some biological plausibility. Alzheimer's disease affects neurotransmitter systems,particularly the cholinergic system. Nicotine is a cholinergicagonist. The . . . [Full text of this article]

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