Observational studyAddiction (Abingdon, England)2022
Long-term associations of cigarette smoking in early mid-life with predicted brain aging from mid- to late life.
Observational study in Addiction (Abingdon, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- BrainAGE, brain health, and mental disorders: A systematic review.Neuroscience and biobehavioral reviews · 2024Pooled it
- Your brain doesn't look a day past 70! Cross-sectional associations with brain-predicted age in the cognitively-intact oldest-old.GeroScience · 2026Article
- Article
- Association of cumulative deficit frailty with brain age and Alzheimer's disease-related brain structure starting in late-middle age.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Association of epigenetic age acceleration with MRI biomarkers of aging and Alzheimer's disease neurodegeneration.medRxiv : the preprint server for health sciences · 2026Article
- Linking Individual Variability of Multi-modal Connectivity, Lifestyle, Psycho-Social Factors and Cognition in Older Adults.Aging and disease · 2025Article
- Brain reserve in midlife is associated with executive function changes across 12 years.Neurobiology of aging · 2024Article
- Genetic and Environmental Influences on Structural and Diffusion-Based Alzheimer's Disease Neuroimaging Signatures Across Midlife and Early Old Age.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2023Article
- Neuroimaging-Derived Predicted Brain Age and Alcohol Use Among Community-Dwelling Older Adults.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2023Observational
- Evaluating the causal effect of tobacco smoking on white matter brain aging: a two-sample Mendelian randomization analysis in UK Biobank.Addiction (Abingdon, England) · 2023Article
- Elevated Pure Tone Thresholds Are Associated with Altered Microstructure in Cortical Areas Related to Auditory Processing and Attentional Allocation.Journal of Alzheimer's disease : JAD · 2023Article
- Neuroimaging-Based Brain Age Estimation: A Promising Personalized Biomarker in Neuropsychiatry.Journal of personalized medicine · 2022Review
- Commentary on Whitsel et al.: Smoking, alcohol use and the brain- the challenge of answering causal questions.Addiction (Abingdon, England) · 2022Article
- The Impact of Genes and Environment on Brain Ageing in Males Aged 51 to 72 Years.Frontiers in aging neuroscience · 2022Article
- Lifestyle and psychosocial associations with cognition at the cusp of midlife using twins and siblings.Alzheimer's & dementia (Amsterdam, Netherlands)Article
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Authors and funding
28 authors.
Funding
Abstract
BACKGROUND AND
aimsSmoking is associated with increased risk for brain aging/atrophy and dementia. Few studies have examined early associations with brain aging. This study aimed to measure whether adult men with a history of heavier smoking in early mid-life would have older than predicted brain age 16-28 years later.
designProspective cohort observational study, utilizing smoking pack years data from average age 40 (early mid-life) predicting predicted brain age difference scores (PBAD) at average ages 56, 62 (later mid-life) and 68 years (early old age). Early mid-life alcohol use was also evaluated.
settingPopulation-based United States sample. PARTICIPANTS/CASES: Participants were male twins of predominantly European ancestry who served in the United States military between 1965 and 1975. Structural magnetic resonance imaging (MRI) began at average age 56. Subsequent study waves included most baseline participants; attrition replacement subjects were added at later waves. MEASUREMENTS: Self-reported smoking information was used to calculate pack years smoked at ages 40, 56, 62, and 68. MRIs were processed with the Brain-Age Regression Analysis and Computation Utility software (BARACUS) program to create PBAD scores (chronological age-predicted brain age) acquired at average ages 56 (n = 493; 2002-08), 62 (n = 408; 2009-14) and 68 (n = 499; 2016-19).
findingsIn structural equation modeling, age 40 pack years predicted more advanced age 56 PBAD [β = -0.144, P = 0.012, 95% confidence interval (CI) = -0.257, -0.032]. Age 40 pack years did not additionally predict PBAD at later ages. Age 40 alcohol consumption, but not a smoking × alcohol interaction, predicted more advanced PBAD at age 56 (β = -0.166, P = 0.001, 95% CI = -0.261, -0.070) with additional influences at age 62 (β = -0.115, P = 0.005, 95% CI = -0.195, -0.036). Age 40 alcohol did not predict age 68 PBAD. Within-twin-pair analyses suggested some genetic mechanism partially underlying effects of alcohol, but not smoking, on PBAD.
conclusionsHeavier smoking and alcohol consumption by age 40 appears to predict advanced brain aging by age 56 in men.
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