Tobacco initiation during childhood linked to reduced brain Structure and cognitive Performance: JAMA

The landscape of tobacco use is changing. However, information about the association between early-age tobacco use and cognitive performances is limited, especially for emerging tobacco products such as electronic cigarettes (e-cigarettes).

A study was conducted to assess the association between early-age initiation of tobacco use and cognitive performances measured by the National Institutes of Health (NIH) Toolbox Cognitive Battery and to examine whether initiation is associated with differences in brain morphometry.

This observational cohort study examined the longitudinal associations of initiation of tobacco use with neurocognition using multivariate linear mixed models. Children aged 9 to 10 years from 21 US sites were enrolled in wave 1 (October 1, 2016, to October 31, 2018 [n = 11 729]) and the 2-year follow-up (August 1, 2018, to January 31, 2021 [n = 10 081]) of the Adolescent Brain Cognitive Development (ABCD) Study.

The results of the study are:

• Among 11 729 participants at wave 1, 116 children reported every use of tobacco products. Controlling for confounders, tobacco ever users vs nonusers exhibited lower scores in the Picture Vocabulary Tests at wave 1
• The crystallized cognition composite score was lower among tobacco ever users than nonusers both at wave 1 and 2-year follow-up
• In structural magnetic resonance imaging, the whole-brain measures in cortical area and volume were significantly lower among tobacco users than nonusers, including the cortical area at wave 1 and cortical volume at wave 1 and follow-up
• Different regions of interest analysis revealed smaller cortical area and volume in multiple regions across both waves' frontal, parietal, and temporal lobes.

Thus, in this cohort study, initiating tobacco use in late childhood was associated with inferior cognitive performance and reduced brain structure with sustained effects at a 2-year follow-up. These findings suggest that youths vulnerable to e-cigarettes and tobacco products should be treated as a priority population in tobacco prevention.

Reference:

Dai HD, et al "Longitudinal assessments of neurocognitive performance and brain structure associated with the initiation of tobacco use in children, 2016 to 2021" JAMA Netw Open 2022;

DOI:10.1001/jamanetworkopen.2022.25991