Adult cigarette smoking rates in the U.S. have fallen to a record low of 9.9% as of 2024. However, a new study published in the American Journal of Ophthalmology indicates that transitioning from traditional cigarettes to electronic vapes may heighten the risk of developing major eye diseases.
The research, conducted by scientists at the Korea University College of Medicine, analyzed health data from nearly 180,000 adults in South Korea who had previously smoked traditional cigarettes. Participants who had quit smoking by 2018 or 2019 were categorized into two groups: those who ceased all nicotine use and those who switched to smokeless nicotine products, such as vapes.
Increased Risk of Vision Impairment
Over an average follow-up period of 4.6 years, researchers observed a total of 6,328 major eye disease events. The group that quit all nicotine products entirely exhibited the lowest incidence rate of eye conditions. In contrast, individuals who switched to alternative nicotine products, including vapes, showed a 7% increased risk of serious eye diseases compared to complete cessation.
Specific findings indicated that users of alternative nicotine products faced a 24% higher risk of developing diabetic retinopathy, a condition that affects the blood vessels in the retina. Additionally, those who switched from cigarettes to vapes experienced a 7% greater risk of refractive and accommodation disorders, which impair the eye's ability to focus.
Study Limitations and Implications
Researchers noted that these findings challenge the common assumption that substituting noncombustible nicotine products for cigarettes is without risk to vision. However, the study's authors acknowledged certain limitations. As the research relied on health insurance data and self-reported questionnaires, it cannot definitively establish a causal link between vaping and eye damage. Potential underreporting or memory errors in self-assessments were also noted.
Despite these limitations, the study suggests that replacing cigarettes with alternative nicotine products may not fully eliminate the risk of certain vision-related health problems. Medical analysts have expressed concerns about the addictive nature of high-nicotine vaping products and nicotine pouches, warning of potential gastrointestinal and cardiovascular issues, and highlighting social media's influence on younger generations' adoption of these products.