Rising dementia mortality among tobacco users in the US, 2005–2020: insights from CDC-WONDER database

BACKGROUND: Dementia is a leading cause of morbidity and mortality in the aging population, with tobacco use recognized as a major modifiable risk factor. Despite this established link, national trends in mortality due to dementia among tobacco users remain underexplored. METHODS: We analyzed deaths due to dementia in tobacco users using the CDC WONDER database from 2005 to 2020. Age-adjusted mortality rates per 100,000 of the US population were calculated and categorized by demographics and region. Joinpoint regression was used to estimate Annual Percent Change and Average Annual Percent Change. RESULTS: A total of 63,623 deaths due to dementia among tobacco users were recorded among older adults aged ≥65 years. The AAMR observed a significantly steep incline from 3.25 in 2005 to 12.87 in 2020. Men observed higher overall AAMR than women. Non-Hispanic White population had the highest overall AAMR. Regionally, the highest AAMR was recorded in the Midwest and non-metropolitan areas. CONCLUSION: Deaths due to dementia among tobacco users has risen sharply in the U.S. with marked disparities by sex, race, and geography. These findings highlight the urgent need for targeted smoking cessation programs and equitable dementia care strategies to mitigate the growing burden.