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CATARACTS AND SMOKING: MORE BAD NEWS FOR SMOKERS

(November 2001)

Eye cataracts are a major health problem in the United States. There are more than one million cataracts extracted each year at a cost of more than $3 billion. Cigarette smoking is a definite risk factor for cataracts and it is dose related - the more you smoke and the longer the duration of smoking, the greater the cataract risk.

It has not been clear whether stopping smoking reduces the subsequent risk of developing smoking-related cataracts. A recent issue of the Journal of the American Medical Association contains an interesting report from the Physicians Health Study about the effectiveness of quitting smoking on cataract risk. One-half the doctors were never smokers and one-fifth current smokers; the others were past smokers.

Those who were past smokers for less than 10, 10 to 20, or more than 20 years had a 21 to 27 percent reduced risk compared to those who continued smoking, but even 20 years after quitting, the risk was still substantially greater than for never smokers.

Commentary: This is a good study. Overall, the various studies indicate that the danger of cataracts among smokers is particularly marked for those who are heavy smokers (at least 1-1/2 packs a day). The benefits of stopping are still not clear; in some studies for those who have been heavy smokers, there appeared to be virtually no benefit from quitting even after 10 or 20 years of non-smoking. Those who smoke less than 1-1/2 packs a day are less likely to develop cataracts and seem more likely to return to non-smoking risk by 10 years after cessation.

That is the case in this study; most of the benefit of stopping appeared to be in those smoking less heavily each day, thus, exposing the eyes to less of the damaging cigarette toxins and tobacco-related oxidant stress. Once the eye damage has occurred, it is not likely it will be reversed by quitting.

for the evidence that heavy smoking is a risk factor for eye cataracts.

for the effect of quitting smoking, meaning we still do not know how much quitting smoking reduces the risk of developing smoking-related cataracts.

Although it is still unclear how much of the damage to the eye is reversible, there is enough evidence to advise those who start or continue smoking that dosage is important in regard to eye damage. Healthful Life strongly recommends no smoking, but, if you must smoke, limiting your daily usage to one-half pack or less a day will at least limit the damage to your eyes - and also to your heart and lungs.

Christen, W.G., et al. Smoking Cessation and Risk of Age-Related Cataracts in Men. Journal of the American Medical Association. Vol 284. Pgs 713-716. 2000.