Smoking linked to higher risk of dementia

by Laura Thomas, Curtin University

edited by Lisa Lock, reviewed by Andrew Zinin

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A major review of more than 2 million people has found current smokers face a higher risk of dementia, with researchers calling for brain health to feature more prominently in antismoking campaigns.

Led by Curtin University researchers, the study examined the link between smoking and three forms of dementia, including all-cause dementia, Alzheimer's disease and vascular dementia, providing the most comprehensive update to the evidence in more than a decade.

The systematic review and meta-analysis examined 61 studies involving about 2.8 million people. The findings are published in the journal eClinicalMedicine.

Researchers found people who currently smoke had a 31% higher risk of developing dementia, a 40% higher risk of Alzheimer's disease and a 52% higher risk of vascular dementia than people who had never smoked.

The study also found the risk of dementia increased with the number of cigarettes smoked.

People smoking 10 cigarettes a day had a 16% higher risk of dementia, while those smoking 20 a day had a 34% higher risk, compared with people who had never smoked.

Lead researcher Mario Siervo, from the Dementia Center of Excellence at Curtin's enAble Institute and School of Population Health, said the findings highlighted the importance of looking beyond the well-known links between smoking, cancer and heart disease.

"We know smoking can cause serious harm to our health, but its impact on brain health also deserves attention," Siervo said. "Our findings show current smoking is linked to a higher risk of dementia, and that risk increases as people smoke more."

Senior author of the paper Blossom Stephan, also from the Dementia Center of Excellence at Curtin's enAble Institute, said the findings highlight the importance of considering the wider health impacts of smoking. "Brain health should be part of the conversation when we talk about the dangers of smoking and the benefits of quitting."

The study also found former smokers had a lower risk of dementia than people who continued to smoke. Overall, former smokers did not have a higher risk of dementia than people who had never smoked.

While the research cannot prove smoking directly causes dementia, the findings add to growing evidence that quitting smoking may be an important part of reducing dementia risk.

Co-author and Dementia Australia chief executive officer Tanya Buchanan said the findings reinforced the importance of helping people understand the modifiable risk factors linked to dementia risk.

"Dementia has a life-changing impact on people, their families and their communities," Buchanan said. "Research like this helps build our understanding of the modifiable risk factors linked to dementia and highlights the importance of looking after our brain health.

"It is equally as important to understand that dementia risk reduction is a shared responsibility, which is why we need policies and actions from all levels of government, alongside providing information and research, to make it easier for all Australians to look after their brain health."

The researchers also highlighted a gap in Australia's approach to tobacco control.

While smoking has been identified as a risk factor for dementia in three major international reports, dementia and brain health are not directly addressed in Australia's National Tobacco Strategy 2023–2030.

Cancer Council WA's cancer prevention and research director, Melissa Ledger, said the findings provided another reason to maintain and refresh public health education campaigns and messages about the dangers of smoking.

"We're really proud to have delivered what we believe was the first Australian smoking and brain health campaign earlier this year, to start raising awareness of the link between smoking and dementia, but there is more to say about the harm smoking can cause," Ledger said. "This research provides an opportunity to talk about the health benefits of quitting smoking in a new way.

"Making sure people understand the full impact of smoking, and the benefits of quitting, is an important part of preventing smoking-related disease."

The researchers said including brain health in antismoking campaigns, cigarette packet warnings and quit-smoking programs could help more people understand the long-term risks of smoking and the benefits of quitting.

They said further research was needed to understand how the age at which a person quits and how long they have been smoke-free affect dementia risk.

Publication details

Mario Siervo et al., Smoking and dementia risk: an updated systematic review and meta-analysis of 61 prospective cohort studies and implications for tobacco control, eClinicalMedicine (2026). DOI: 10.1016/j.eclinm.2026.104310

Journal information: EClinicalMedicine

Key medical concepts

SmokingAlzheimer's DiseaseDementia, Vascularsmoking cessation therapy

Clinical categories

NeurologyCommon illnesses & PreventionPreventive medicineHealthy living Provided by Curtin University Who's behind this story?

Lisa Lock

BA art history, MA material culture. Former museum editor, paramedic, and transplant coordinator. Editing for Science X since 2021. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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