Patients with fibromyalgia who use tobacco products are at greater risk for cognitive impairment and other symptoms that affect quality of life, according to the results of a study from the Mayo Clinic in Rochester, MI.

Fibromyalgia is a common disorder affecting more than five million Americans. Although widespread pain is a fundamental symptom, cognitive impairment is actually one of the major manifestations and is sometimes colloquially referred to as “fibrofog.” Cognitive impairment may be even more disabling than pain symptoms, leading to memory decline, mental confusion, and concentration difficulties.

To identify potential risk factors, D’Souza et al. investigated the association of tobacco use and cognition in 668 patients with fibromyalgia from May 2012–November 2013. Specifically, the researchers found an association of worse overall cognitive function, language, verbal memory, visual-spatial memory, and concentration. They also identified that tobacco use was associated with increased fibromyalgia symptom severity, worse quality of life, worse sleep, and increased anxiety and depression.