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Several studies have shown that nicotine can improve cognitive impairment in Alzheimer's disease by enhancing protein kinase B activity and stimulating phosphoinositide 3-kinase/Akt signaling pathways, which are crucial for learning and memory processes

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Exposure to cigarette smoke leads to increased permeability of the respiratory epithelium, mucous overproduction, impaired mucociliary clearance, enhanced release of pro-inflammatory cytokines and chemokines with consecutive recruitment of macrophages and neutrophils, as well as altered pathogen sensing and clearance

Furthermore, a Korean smoker's puff volume was 73 mL, 2.1 times the international standard of 35 mL, and the number of puffs per cigarette was 20.4, 1.6 times the international standard of 13