Smoking and Alcohol

Don't smoke and avoid excess alcohol.

⏱ 2 min read

Cigarette smoking

Studies have shown that smoking increases the risk of Alzheimer disease and may increase the risk of other dementias. In some large studies, smokers had close to double the risk of developing dementia. On repeated cognitive testing, people who smoke show greater annual declines than non-smokers.

This reinforces the need to quit smoking, especially for those aged 65 or older, to help promote brain health. Of course, there are other non-brain-related benefits of quitting smoking, such as decreasing risk of stroke, heart disease, peripheral vascular disease, cancer, and chronic lung diseases (like COPD).

The Smokers’ Helpline can help you quit successfully, or talk with your health care team. Many pharmacies also offer smoking cessation programs.

Alcohol use

Heavy drinking is associated with brain changes, cognitive impairment, and dementia. People with alcohol use disorders have a higher risk of dementia, and they have an earlier onset as well.

More recent Guidelines from the Canadian Centre on Substance Use and Addiction (CCSA) have highlighted many of the other health risks associated with alcohol consumption. Their report underlines that even a small amount of alcohol can be damaging to health, and that drinking less is better.

Have a look at the CCSA infographic which outlines different levels of health risks based on the number of drinks per week. Any amount over 2 drinks per week is considered a moderate or higher risk to your health.

Chart of negative consequences of alcohol consumption based on weekly consumption

(c) Canadian Centre on Substance Use and Addiction, 2023.

However, if you’re cognitively impaired or it’s impacting your sleep, little or no alcohol may be recommended. Older adults are more sensitive to the effects of alcohol and will be more impaired when consuming the same amount of alcohol as when they were younger. It can also increase your risk of a traumatic brain injury, which also increases your risk of dementia.

Heavy drinking should be avoided by people of all ages, regardless of their level of cognitive function. If you have an alcohol use disorder, treatments may reduce your risk of cognitive decline and dementia.

Ways to drink less

Here are some suggestions from the CCSA on some helpful ways to reduce your alcohol use.

  • Count how many drinks you have in a week.
  • Set a weekly drinking target.
  • If you’re going to drink, made sure you don’t exceed 2 drinks on any day; 1 if you are older.
  • You can reduce your drinking in steps. Every drink counts: any reduction in alcohol use has benefits.

Tips to help you stay on target:

  • Stick to the limits you’ve set for yourself.
  • Drink slowly.
  • Drink lots of water.
  • For every drink of alcohol, have one non-alcoholic drink.
  • Choose alcohol-free or low-alcohol beverages.
  • Eat before and while you’re drinking.
  • Have alcohol-free weeks or do alcohol-free activities.


Canadian Centre on Substance Use and Addiction, 2023. Canada’s Guidance on Alcohol and Health, Public Summary: Drinking Less is Better (Infographic).


Learn more about Canada’s Guidance on Alcohol and Health.

Key points from this topic

  • Don’t smoke.
  • If you drink, it’s better to drink less.


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What other people are saying:

"This study has been a real eye-opener, as it has educated and informed me on concepts I previously did not associate with the risk of developing dementia." - Study participant, 25-34 years old.

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Anthony Levinson

Anthony J. Levinson, MD, MSc, FRCPC

Neuropsychiatrist, Professor; Faculty of Health Sciences, McMaster University

About this Project

Who authored and edited this page?

This page was developed by the Division of e-Learning Innovation team and Dr. Anthony J. Levinson, MD, FRCPC (Psychiatry). Dr. Levinson is a psychiatrist and professor in the Department of Psychiatry and Behaviour Neurosciences, Faculty of Health Sciences, McMaster University. He is the Director of the Division of e-Learning Innovation, as well as the John Evans Chair in Health Sciences Educational Research at McMaster. He practices Consultation-Liaison Psychiatry, with a special focus on dementia and neuropsychiatry. He is also the co-developer of the dementia care partner resource, and one of the co-leads for the McMaster Optimal Aging Portal. He and his team are passionate about developing high-quality digital content to improve people's understanding about health. By the way, no computer-generated content was used on this page. Specifically, a real human (me) wrote and edited this page without the help of generative AI like ChatGPT or Bing's new AI or otherwise.

Are there any important disclosures or conflicts of interest?

Dr. Levinson receives funding from McMaster University as part of his research chair. He has also received several grants for his work from not-for-profit granting agencies. He has no conflicts of interest with respect to the pharmaceutical industry; and there were no funds from industry used in the development of this website.

When was it last reviewed?

August 22, 2023

What references and evidence were used to create this content?

Content was written and adapted based on credible, high-quality, non-biased sources such as MedlinePlus, the National Institutes for Mental Health, the McMaster Optimal Aging Portal, the American Psychiatric Association, the Cochrane Library, the Centre for Addictions and Mental Health (CAMH) and others. In particular, evidence-based content about dementia risk reduction was also derived from the World Health Organization and the Lancet Commission reports. Please see additional references on the e-learning lesson landing page

Who funded it?

The initial development of some of this content was funded by the Centre for Aging and Brain Health Innovation, powered by Baycrest. Subsequent funding was through support from the McMaster Optimal Aging Portal, with support from the Labarge Optimal Aging Initiative, the Faculty of Health Sciences, and the McMaster Institute for Research on Aging (MIRA) at McMaster University, and the Public Health Agency of Canada. There are no conflicts of interest to declare. There was no industry funding for this content.