Nicotine Tob Res. 2023 Jul 9:ntad117. doi: 10.1093/ntr/ntad117. Online ahead of print.
ABSTRACT
INTRODUCTION: Tobacco is a well-established risk factor for cancer, but its association with other morbidities needs consideration. The low-income and middle-income countries with unprecedented demographic transformation lack evidence on tobacco use and its impact on cognitive health.
METHODS: Using a propensity score matching approach, we utilized data from the Longitudinal Ageing Study of India. Study employed 1:1 nearest neighbor matching with the replacement methodology. We estimated the odds of poor cognitive score and tobacco use among older adults based on five different models for ever tobacco user, former tobacco user, current tobacco user, current smokers, and current smokeless tobacco users with reference to never tobacco users.
RESULTS: The estimated average treatment effect (ATT) for treated and the untreated group has shown a higher likelihood of cognitive decline among ever (OR -0.26; 95%CI -0.43 to -0.09), current (OR -0.28; 95%CI -0.45 to -0.10) and former (OR -0.53; 95%CI -0.87 to -0.19) tobacco users compared to never tobacco users compared to never tobacco users. Finding further suggests that odds of lower cognitive score among older adults who were smoker (OR -0.53; 95%CI -0.87 to -0.19) and smokeless tobacco user (OR -0.22; 95%CI -0.43 to -0.01).
CONCLUSIONS: Interventions designed to prevent and prolong the incidence of cognitive impairment should focus on limiting the use of tobacco. Strategies under tobacco-free generation initiative should be amplified in order to prevent future generation from productivity loss and to promote healthy ageing and premature deaths.
IMPLICATIONS: Evidence of a definitive association between tobacco consumption and cognition among older adults is sporadic in low-income and middle-income countries (LMICs). Though tobacco is a risk factor for various diseases including cancer, the extent of its impact on cognitive health among older population is limited. This study contributes to existing literature by highlighting poor cognitive outcomes among older adults who smoke tobacco and consume smokeless tobacco as compared to never tobacco users. Our findings emphasize the need to accelerate tobacco-free generation efforts in LMICs to reach a higher quality of life and active ageing in pursuit of achieving the sustainable development goal of ‘good health and well-being’.
PMID:37422916 | DOI:10.1093/ntr/ntad117
