Current Respiratory Medicine Reviews · Oct 29, 2026
Smoking-induced Neuroinflammation: A Mechanistic Pathway for Accelerated Brain Aging and Neurodegeneration
By Aziz R, Jawed F, Khan A et al.
Tobacco smoking remains a significant global health challenge, with India having one of the highest burdens of tobacco-related morbidities. While the pulmonary and cardiovascular consequences of smoking are well established, emerging evidence reveals profound neurological implications that warrant attention from respiratory care practitioners. This review examines the complex neuro-inflammatory mechanisms through which smoking accelerates brain aging and increases the risk of neurodegenerative disease, with particular relevance to respiratory care practice. A comprehensive literature search was conducted across PubMed, ScienceDirect, and Web of Science databases (2000-2025) using keywords including "smoking," "neuro-inflammation," "brain aging," "microglia," "oxidative stress," and "neurodegeneration”. Cigarette smoke triggers multifaceted neuroinflammatory cascades involving microglial activation, blood-brain barrier disruption, oxidative stress, and epigenetic modifications. These pathways create persistent brain inflammation, contributing to accelerated aging and a 30-50% increased dementia risk. Neuroimaging studies have demonstrated dose-dependent reduction in brain volume and cortical thinning in smokers. Understanding smoking-induced neuro-inflammation is crucial for respiratory care professionals, as it represents a preventable pathway for neurodegeneration. This knowledge can inform comprehensive patient counseling and cessation strategies that emphasize both respiratory and neurological benefits.