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If a smoker and a nonsmoker were each to take a memory test, the nonsmoker would probably do better. We've known for years that smokers don't remember names and faces as well as nonsmokers do. But we didn't know the extent of the disparity until recently, when a large study found that smokers exhibited a far steeper decline in memory and related cognitive functions than did nonsmokers.

In a 2004 study published in the journal Neurology, 9,209 people ages sixty-five and older were evaluated on an annual basis with the Mini-Mental State Examination, a standard test of cognitive functions, for several years. Scores declined slightly for most participants during this period, but the decline was five times greater for smokers than for people who never smoked. The decline was most pronounced among people who smoked the most cigarettes over the longest period of time.

A link between cigarette smoking and memory has also been reported in research with middle-aged individuals. A 2003 British study found a direct connection between smoking and weaker verbal memory performance in people between the ages of forty-three and fifty-three.

There are several ways that smoking might impair cognitive function, primarily related to its role as a major risk factor for cerebrovascular disease. Smoking damages the lungs, and good lung function is important for optimal memory function in aging. Smoking also constricts blood vessels, thereby depriving the brain of the oxygen necessary to nourish and support neurons. Nutritional factors may also play a role in the smoking-memory connection; smokers tend to have lower intake of antioxidants and higher levels of cholesterol and triglycerides. There are many unknowns, but one bit of encouraging news is that smoking cessation seems to benefit the brain. In the previously cited 2004 study, former smokers exhibited less cognitive decline than current smokers.

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