Study shows patients with AMD deny smoking more often than those without

A researcher has found that patients who smoke and have age-related macular degeneration fail to self-report smoking more frequently than patients in the general U.S. population.

Mark W. Swanson, OD, MSPH, FAAO, reported in Optometry & Vision Science that smoking has been identified as a major modifiable risk factor for AMD.

“Most, but not all, studies of smoking and macular degeneration have noted an excess risk, with some studies reporting 100% increases among active smokers,” he said.

“Smoking deception, or failing to self-report as a smoker, is a recognized concern in studies involving reports of active smoking status,” he continued. “Studies specifically investigating the underreporting of active smoking have noted rates from a low of 1% to as high as 79%.”

Swanson said that he used estimates of smoking deception from the 2005 to 2008 National Health and Nutrition Examination Survey. Patients considered for Swanson’s cohort were at least 40 years old and had cotinine levels performed and gradable fundus photos for both eyes, for a total of 4,639 subjects.

Any level of AMD was found in 6.7% of the cohort, Swanson reported. He said that self-reporting of cigarette and nicotine usage in those with any level of AMD and those at risk of late-stage AMD was slightly less than that seen in the general U.S. population.

“For both individuals with AMD and at risk for late AMD, about 5% are potential smoking deceivers,” Swanson said. “This is not a large prevalence at the individual level; however, given the approximate 9.5 million people at risk for late AMD, this equates to more than 450,000 persons within the U.S. population who may misidentify themselves as nonsmokers.”