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  • E-Cigarettes May Harm Vision

    By Lynda Seminara
    Selected by Richard K. Parrish II, MD
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    Journal Highlights

    American Journal of Ophthalmology, March 2022

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    It is well known that smoking tradi­tional cigarettes increases the risk of various ocular diseases, but the effects of e-cigarettes on eye health have not been determined. In a population-based study, Golla et al. explored the relationship between e-cigarette use and perceived visual impairment. They found that people who never smoked e-cigarettes were less likely to have problems with vision.

    The analysis was based on data from the 2016-2018 Behavioral Risk Factor Surveillance System, a nationwide tele­phone survey conducted annually by the CDC in all 50 states and three U.S. territories. In the study, e-cigarette use was categorized as current, former, or never, based on responses to the ques­tions “Have you ever used an e-cigarette or other electronic vaping product, even just one time, in your entire life?” and “Do you now use e-cigarettes or other electronic vaping products every day, some days, or not at all?” E-vaping products for marijuana were excluded.

    The main outcome measure was visual impairment, determined by a “yes” or “no” answer to the question “Are you blind or do you have serious difficulty seeing, even when wearing glasses?” A subgroup analysis was performed for respondents who never smoked traditional cigarettes.

    The study population included more than 1 million adults. Relative to respondents who never used e-cigarettes, the adjusted odds ratio for visual impairment was 1.34 for current users and 1.14 for former users. Younger age was associated with greater use of e-cigarettes, and older age increased the likelihood of visual impairment. Among the subset that never smoked traditional cigarettes, the adjusted odds ratio of visual impairment was 1.96 for current e-cigarette users and 1.02 for previous users.

    The authors acknowledged that a causal relationship cannot be estab­lished from an observational study. However, the results suggest that smoking e-cigarettes may impair vision and that this occurs independently of smoking status for traditional ciga­rettes. This may relate to traits shared by both types of cigarettes, such as the nicotine component and elevation of oxidative stress, said the authors. As a next step, they recommend longitudi­nal studies in lieu of randomized trials because the latter would pose ethical and health concerns.

    The original article can be found here.