Effect of Smoking in Cognition among Male Medical Students Karishma Rajbhandari Pandey 1* , Dipesh Raj Panday 2 , Nidesh Sapkota 3 , Anish Dhami 4 , Akshay Sarraf 4 , Sandeep Shrestha 4 and Deependra KC 4 1 Department of Basic and Clinical Physiology, B.P. Koirala Institute of Health Sciences (BPKIHS), Nepal 2 Department of Clinical Pharmacology and Therapeutics, BPKIHS, Nepal 3 Department of Psychiatry, BPKIHS, Nepal 4 B.P. Koirala Institute of Health Sciences, Nepal * Corresponding author: Karishma Rajbhandari Pandey, Assistant Professor, Department of Basic and Clinical Physiology, BPKIHS, Dharan, Nepal, Tel: +9779841377749; +09779862124700; E-mail: karishma@bpkihs.edu Received date: February 23, 2017; Accepted date: April 03, 2017; Published date: April 10, 2017 Copyright: © 2017 Pandey KR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Introduction: Smokers claim that smoking increases their concentration, alertness, and overall mental performance. On the contrary, evidences point at gradual cognitive deterioration in smokers. Cognitive deterioration can be assessed by Montreal cognitive assessment (MoCA). Objective: To compare the cognitive status in smoker and non-smoker medical students. Materials and methods: A cross-sectional comparative study was done in 46 male medical students with normal cardiac and pulmonary functions (23 smokers and 23 non-smokers, FTND was used to establish smoking status) at Pulmonary Function Lab in the Department of Basic and Clinical Physiology, BP Koirala Institute of Health Sciences. Pulmonary function tests (PFT) were measured to exclude pulmonary function defect. Blood Pressure (SBP and DBP) was used to ascertain subjects with normal and abnormal cardiac function. For cognition assessment Montreal cognitive assessment (MoCA), which is a close ended questionnaire, was used. Data were expressed in median and Inter-Quartile-Range (IQR). Chi-square Test was applied to observe association between smoking and cognition (normal vs. impaired cognition). Results: All baseline variables viz., anthropometric (Age and BMI), cardiovascular (Diastolic and Systolic Blood Pressures) and pulmonary function (VC, FEV1 and FEV1/FVC) were comparable between smokers and non- smokers except age. Greater percentage of smokers compared to non-smokers (48% vs. 22%) had mild cognitive decline as measured by MoCA score. However, the finding was statistically non-significant (0.063). Conclusion: Low nicotine-dependent male medical students with normal pulmonary and cardiac functions, showed mild but insignificant cognitive decline as measured by MoCA score. Keywords: Cognition; Pulmonary function; Smoking Introduction Smoking status has been established as a risk factor for non- communicable diseases, which are one of the prime causes of death and disability of millions of people year in and year out [1]. Te World Health Organization (WHO) has also predicted that 1.5 to 1.9 billion people worldwide will be smokers by 2025. Smoking continues to rise in especially in developing countries. Impact of smoking on respiratory and cardiovascular system has already been well established. However, its efect on central nervous system still remains contradictory. Most of the studies were inconclusive about the efect of smoking on cognition [2]. Nicotine is a potent addictive agent in cigarettes. Smokers link it to increased alertness, concentration and overall mental performance [3,4]. Neuro-imaging studies have shown that Nicotine induces enhanced activity in some regions involved with attention and cognition viz., thalamus, lateral frontoparietal cortices, anterior cingulate cortex whereas decreasing activity in other regions involved with task-irrelevant mental operations such as mind-wandering; ventromedial prefrontal cortex, posterior cingulate cortex, parahippocampus [5-7]. Whereas studies show gradual cognitive decline in smokers [8,9]. Among diferent available cognitive tests, Montreal cognitive assessment (MoCA), a one-page, 30-point test administered in approximately 10 min, is one of the sensitive and valid tools to assess even mild cognitive impairment [10]. Our study aimed to see the relation between smoking and cognition in young male medical students without any chronic cardio-respiratory impairment as yet. We hypothesized that smoking causes cognitive decline even in early years of life. Methods Te study was carried out at the Pulmonary Function Lab, Department of Basic and Clinical Physiology of BP Koirala Institute of Health Sciences (BPKIHS). Sampling frame (population) was male medical (MBBS) students in the institute. However, participants with history of DM-1/2, HTN, COPD, Bronchial Asthma, Psychiatric medication or with positive family history of Parkinsonism/ Alzheimer’s were excluded. Tose using tobacco in other forms than smoking were also excluded from the study. Only male medical students, aging 20-40 years, with BMI<25 kg/m 2 without history of Research Article OMICS International J Addict Res Ter, an open access journal ISSN:2155-6105 Volume 8 • Issue 2 • 1000316 Pandey et al., J Addict Res Ther 2017, 8:2 DOI: 10.4172/2155-6105.1000316 Journal of Addiction Research & Therapy J o u r n a l o f A d d i c t i o n R e s e a r c h & T h e r a p y ISSN: 2155-6105