Long-Term Smoking Cessation Slows Cognitive Decline in Adults: Daily Dose

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On October 14, 2025, we reported on findings from a study published in The Lancet Healthy Longevity that examined whether long-term cognitive trajectories improved following mid-to-late-life smoking cessation.

The study

Investigators tapped data from 3 large nationally representative cohort 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). They matched matched 4,718 participants who quit smoking with 4,718 continuing smokers based on demographic, socioeconomic, and cognitive criteria, then examined memory and fluency trajectories using piecewise linear mixed models.

The final analytic sample comprised 9436 individuals (mean baseline age 58.3 years, 52% women) distributed across England, the United States, and 10 European countries. Smokers who quit reported a mean of 12.1 cigarettes daily compared with 13.5 daily in continuing smokers. The 3 cohorts administered identical cognitive tests—immediate and delayed recall for episodic memory and animal naming for verbal fluency—ensuring a harmonized analysis.

The findings

In the 6 years following smoking cessation, memory decline slowed by approximately 20% and verbal fluency decline by roughly 50% compared with continuing smokers, translating to 3 to 4 months less memory decline and 6 months less fluency decline with each year of aging.

Authors' comments

"Cumulative evidence indicates that the cognitive harms of smoking are not necessarily permanent and might be mitigated by smoking cessation. Our findings suggest that smoking cessation even later in life can have meaningful benefits for long-term cognitive function."

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