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# Varenicline users had about half the dementia risk of nicotine-replacement users
- URL: https://www.coios.me/varenicline-users-had-about-half-the-dementia-risk-of/
- Published: 2026-09-21T08:40:00.000Z
- Updated: 2026-09-21T08:41:10.000Z
- Description: Among 3,516 propensity-matched adults aged 50 and over starting smoking cessation in the US All of Us cohort, varenicline was associated with a lower rate of incident Alzheimer's disease and related dementias than nicotine replacement (HR 0.52, 95% CI 0.35-0.75), in a preprint.
- Author: Daniel Ryan
- Tags: Healthcare today, Dementia, Smoking and vaping, United States, #preprint, #new, #item, #source-2026-09

The authors matched 1,758 varenicline initiators to 1,758 nicotine replacement users aged 50 or older in All of Us, on demographics, comorbidities, BMI and prior medications, over 2006 to 2023\. Varenicline was associated with a hazard ratio of 0.52 (95% CI 0.35-0.75) for incident dementia and 0.66 (0.50-0.86) for dementia or death combined. The drug was picked out by a medication-wide association screen rather than a prior hypothesis, so this is a signal to test rather than an established effect.

*Why it is interesting: An existing cessation drug, not an amyloid agent, tracks with lower dementia incidence in a population defined by its smoking history.*

Source

[medRxiv, 20 September 2026](https://doi.org/10.64898/2026.09.17.26363232?ref=coios.me)

DOI

10.64898/2026.09.17.26363232

Type

Preprint

Design

Propensity-matched active-comparator cohort in All of Us, 9,584 initiators aged 50+ (1,758 matched pairs), 2006-2023

Verdict

New finding

Driver

[Dementia](https://www.coios.me/d-dementia/)

Driver

[Smoking and vaping](https://www.coios.me/d-smoking-vaping/)