If you believe that quitting smoking at an older age—whether for yourself or an elderly family member—offers little to no health benefit, take heart.
According to a new study, it is never too late to quit smoking and experience health benefits—even in middle or later life—as giving up the habit may significantly slow the rate of cognitive decline in older adults.
The study, published in The Lancet Healthy Longevity, analysed data from 9,436 individuals aged 40 and above (average age 58) across 12 countries. Researchers compared the cognitive performance of individuals who had quit smoking with a matched group who continued to smoke, over a six-year period.
The findings revealed that those who quit smoking experienced a significantly slower decline in cognitive functions, particularly in verbal fluency and memory. While memory decline slowed by approximately 20 per cent, the deterioration in verbal fluency was halved when compared to those who continued smoking.
The researchers observed that, prior to quitting, cognitive trajectories were similar between the two groups. However, after cessation, those who had quit showed a marked improvement in cognitive preservation.
“Our study suggests that quitting smoking may help people to maintain better cognitive health over the long term, even if they quit in their 50s or later,” said Dr. Mikaela Bloomberg from the UCL Institute of Epidemiology & Health Care, and lead author of the study.
“While physical health improvements following smoking cessation are well documented, our findings indicate that the benefits extend to cognitive health as well,” she added.
Smoking is known to negatively impact cardiovascular health, which in turn affects brain function. It also causes chronic inflammation and oxidative stress, both of which are linked to cognitive impairment. Given these mechanisms, the observed link between quitting smoking and slower cognitive decline may also imply a reduced risk of dementia.
Professor Andrew Steptoe, co-author of the study, noted, “Slower cognitive decline is associated with reduced dementia risk. Although this was an observational study, the results support the growing body of evidence suggesting that smoking cessation could be a potential preventative strategy against dementia.”
The data for the study was drawn from three longitudinal studies: the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), and the Health and Retirement Study (HRS) in the United States. Participants were surveyed every two years, providing insights into changes in cognitive function over time.
More than 4,700 individuals who had quit smoking were compared with an equal number of current smokers. Both groups were matched in terms of age, sex, educational background, country of residence, and initial cognitive performance.
In practical terms, the research team calculated that each year of ageing after quitting was associated with three to four months less memory decline and six months less decline in verbal fluency when compared to continued smokers.
While the study does not establish a causal relationship, the consistency of the findings with earlier research strengthens the argument that smoking cessation at any age is beneficial—not just for physical health, but for cognitive well-being as well.
Dr. Uma Kumar, Head of Rheumatology Department at Delhi-based All India Institute of Medical Sciences (AIIMS) and strong supporter of anti-tobacco campaign, said as policymakers across the globe grapple with the challenges of ageing populations, these findings make the case for investment in tobacco control initiatives targeted at older adults, who are often less likely to attempt quitting despite facing higher risks from continued smoking. Dr Uma Kumar was not part of the global study.
The findings of the study hold importance for India given that its population pyramid is undergoing a marked shift, with projections indicating a substantial rise in the proportion of middle-aged and elderly individuals in the coming decades. Tobacco use remains significantly higher among adults over the age of 45 compared to younger cohorts, and this age group also bears a disproportionate burden of chronic diseases and multimorbidity.
Research has consistently shown that smoking-attributable mortality increases with age. However, individuals in this demographic are also more likely to succeed in quitting tobacco, offering a critical window for public health intervention.
