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Cigarette smoking was reported at baseline 1968 (mean age=44 years) and at follow-up in 1974\u20131975 and 1980\u20131981. CT of the brain was conducted 32 years after baseline examination (mean age=76 years) to evaluate cortical atrophy and white matter lesions. Multiple logistic regressions estimated associations between midlife smoking and late-life brain lesions. The final analyses were adjusted for alcohol consumption and several other covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Smoking in 1968\u20131969 (adjusted OR 1.85; 95%\u2009CI 1.12 to 3.04), in 1974\u20131975 (OR 2.37; 95%\u2009CI 1.39 to 4.04) and in 1980\u20131981 (OR 2.47; 95%\u2009CI 1.41 to 4.33) were associated with late-life frontal lobe atrophy (2000\u20132001). The strongest association was observed in women who reported smoking at all three midlife examinations (OR 2.63; 95%\u2009CI 1.44 to 4.78) and in those with more frequent alcohol consumption (OR 6.02; 95%\u2009CI 1.74 to 20.84). Smoking in 1980\u20131981 was also associated with late-life parietal lobe atrophy (OR 1.99; 95% CI 1.10 to 3.58). There were no associations between smoking and atrophy in the temporal or occipital lobe, or with white matter lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Longstanding tobacco smoking was mainly associated with atrophy in the frontal lobe cortex. A long-term stimulation of nicotine receptors in the frontal neural pathway might be harmful for targeted brain cell.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-072803","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T06:52:26Z","timestamp":1696834346000},"page":"e072803","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Longstanding smoking associated with frontal brain lobe atrophy: a 32-year follow-up study in women"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0564-365X","authenticated-orcid":false,"given":"Lena","family":"Johansson","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden"},{"name":"Department of Addiction and 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