Longitudinal Assessments of Neurocognitive Performance and Brain Structure Associated With Initiation of Tobacco Use in Children, 2016 to 2021

Abstract

Key Points Question How is initiation of tobacco use, including electronic cigarettes, cigarettes, and other tobacco products, at an early age associated with children’s neurocognitive functions? Findings In this national cohort study of 17 073 children with neuroimaging outcomes, a significant association was found of early-age initiation of tobacco use with lower crystalized cognition composite score and impaired brain development in total cortical area and volume. Region of interest analysis also revealed smaller cortical area and volume across frontal, parietal, and temporal lobes. Meaning These findings suggest that initiation of tobacco use is associated with inferior neurocognitive functions; evidence-based intervention strategies and tobacco control policies should prevent tobacco initiation at a young age.

Understanding the Association of Childhood Tobacco Use With Neuropathological Outcomes and Cognitive Performance Deficits in Vulnerable Brains

“…The findings reported by Dai and colleagues raise many important questions for future clinical and preclinical investigations. Notably, it will be important to determine how persistent these pathophysiological outcomes remain beyond the windows of prepubertal and adolescent brain maturation.…”

“…For example, in preclinical animal models, adolescent nicotine exposure has been reported to cause long-term dysregulation of cortical and subcortical affective and cognitive neural networks involving dopamine and glutamate signaling, as well as disruption of molecular signaling pathways associated with cognitive disturbances and mood and anxiety disorders. 4,5 Dai and colleagues 6 present compelling and novel clinical data demonstrating some significant and deleterious associations of childhood smoking behaviors and nicotine exposure with neurodevelopmental trajectories and cognitive performance measures. Using an integrative combination of cognitive testing measures, morphometric assays, and structural magnetic resonance imaging, the authors found that exposure to e-cigarettes and/or other tobacco products among a cohort of children aged 9 to 10 years selected from a socioeconomically and ethnographically diverse sample from the US displayed significant and enduring cognitive impairments.…”

“…Using an integrative combination of cognitive testing measures, morphometric assays, and structural magnetic resonance imaging, the authors found that exposure to e-cigarettes and/or other tobacco products among a cohort of children aged 9 to 10 years selected from a socioeconomically and ethnographically diverse sample from the US displayed significant and enduring cognitive impairments. Using a battery of cognitive assays, the authors reported significant performance deficits in children exposed to In terms of neuropathological outcomes, using structural magnetic resonance imaging and morphometric analyses, Dai and colleagues 6 found that several whole-brain measures were significantly lower among participants exposed to tobacco during childhood, including reductions in total cortical area and volume along with significant reductions in cerebral white matter volume. In addition, the authors found additional structural associations, including lower cortical surface areas in the superior frontal, medial orbitofrontal, paracentral, inferior parietal, middle temporal, superior temporal sulcus, and several other neural regions.…”

“…Dai and colleagues present compelling and novel clinical data demonstrating some significant and deleterious associations of childhood smoking behaviors and nicotine exposure with neurodevelopmental trajectories and cognitive performance measures. Using an integrative combination of cognitive testing measures, morphometric assays, and structural magnetic resonance imaging, the authors found that exposure to e-cigarettes and/or other tobacco products among a cohort of children aged 9 to 10 years selected from a socioeconomically and ethnographically diverse sample from the US displayed significant and enduring cognitive impairments.…”

“…In terms of neuropathological outcomes, using structural magnetic resonance imaging and morphometric analyses, Dai and colleagues found that several whole-brain measures were significantly lower among participants exposed to tobacco during childhood, including reductions in total cortical area and volume along with significant reductions in cerebral white matter volume. In addition, the authors found additional structural associations, including lower cortical surface areas in the superior frontal, medial orbitofrontal, paracentral, inferior parietal, middle temporal, superior temporal sulcus, and several other neural regions.…”