This article is more than 5 years old. Information may no longer be current.
Study: Smoking cessation increasingly lowers cataract risk
In a study to assess the relationship between smoking and cataract risk, researchers found that smoking cessation decreases the risk of cataracts with time.
Lindblad and colleagues reported in JAMA Ophthalmology that they followed a total of 44,371 men, 45 to 79 years old, from Jan. 1, 1998, through Dec. 31, 2009. The participants filled out questionnaires on their smoking habits and lifestyles and were then matched with the Swedish National Day-Surgery Register and local records of cataract extraction.
The researchers found that smokers of more than 15 cigarettes a day had a 42% increased risk of cataract extraction compared with men who had never smoked. It also found that men who smoked an average of more than 15 cigarettes a day but had stopped smoking more than 20 years earlier had a 21% increased risk.
"We observed a positive association between cigarette smoking and cataract extraction in this population-based prospective cohort of men, with a significant dose response for both intensity and the cumulative effect of smoking compared with never smokers," the authors reported in the study. "Smoking cessation was associated with a statistically significant decrease in risk with increasing time from stopping smoking. Even heavy smokers had some benefit from quitting smoking, indicating that the lens has some capability to recover, although more than 2 decades after quitting smoking, the risk did not reach the level of never smokers."
The researchers also published a study in 2005 detailing the relationship between smoking cessation and cataract risk in women. Similarly, they found that after cessation of smoking, risk decreased with time. However, they also found that smokers with a lesser smoking intensity had a small and statistically insignificant increased risk compared to never smokers.
Women who smoked 6 to 10 cigarettes a day but had ceased smoking 10 years earlier, and women who smoked more than 10 cigarettes a day but had ceased smoking 20 years earlier were found to have a relative risk of cataracts not significantly different from women who had never smoked.
"Smoking cessation seems to decrease the risk of cataract extraction with time, although the risk persists for decades. The higher the intensity of smoking, the longer it takes for the increased risk to decline. These findings emphasize the importance of early smoking cessation and, preferably, the avoidance of smoking," the authors concluded.
Perspective
Back to Top
Regarding the summary of the study, I do not think most clinicians will be surprised to learn that smoking affects cataract incidence or severity. We already have data to support the increased risk and severity of smoking in age-related macular degeneration patients. Quitting smoking has already been a recommended treatment for our AMD patients for years.
With increasing awareness and more studies dedicated to this issue, I would suspect eye care practitioners to start discussing the link to cataract progression with their patients as well.
There have been studies looking at what makes a smoking patient decide to quit – or at least attempt to quit. A recommendation from a health care professional, linked to their current health or future medical conditions, increases the chance patients will quit. It has shown to be just as effective as some of the smoking cessation medications available.
I look forward to using the results of the recent study to further discuss the risk of smoking on our most precious and invaluable sense of sight.
Perspective
Back to Top
The Lindblad study brings yet another perspective on the negative impact of smoking on the human body. It has been well established for some time that nicotine has a direct effect on the health of the macula and the potential for AMD. This prospective study of male smokers shows definitively that significant cigarette use (greater than 15/day) increases the risk of cataract development that leads to the need for surgical intervention.
It also demonstrates a positive relationship between cessation of nicotine use and a regression of the effect over a 20-year time period to approximately 50% less than continuing smoking but does not reach the level of nonsmokers.
This gives clinicians another valuable tool to address the ocular health-related concerns in our patients in regard to nicotine and the damaging effects on visual function.