Transitioning from traditional cigarettes to vaping e-cigarettes, particularly those with high nicotine content, is associated with a higher risk of developing severe eye diseases, including those that can lead to blindness, according to a study from South Korea. The findings challenge the perception of vaping as a significantly safer alternative to smoking.
The study, which analyzed data from the Korean National Health Insurance Service, tracked over 179,000 adults who had smoked cigarettes and subsequently quit them between 2011-2012 and 2018–2019. Researchers then focused on a subset of approximately 32,000 participants. Using a statistical method to balance groups based on factors such as age, income, physical activity, and pre-existing health conditions, they compared individuals who quit nicotine entirely with those who switched to vaping.
Over an average follow-up period of 4.6 years, researchers observed 6,328 major eye disease events. The group that completely quit nicotine had the lowest rate of eye diseases at 41 cases per 1,000 person-years. In contrast, those who switched to vaping experienced a rate of 44 cases per 1,000 person-years. Overall, switching to vapes was linked to a seven percent increased risk of serious eye disease compared to complete nicotine cessation.
Specific Conditions and Nicotine's Role
While the overall increase in risk was modest, the study identified a stronger association with specific conditions. Those who switched to vaping faced a 24 percent higher risk of developing diabetic retinopathy compared to individuals who quit all nicotine. Diabetic retinopathy is a condition that damages the retina's blood vessels, often affecting people with diabetes and potentially leading to blindness.
Researchers suspect that nicotine itself is the primary culprit. Nicotine is known to constrict blood vessels, reduce oxygen supply to tissues, and promote chronic inflammation, all of which can negatively impact eye health over time. This mechanism is believed to contribute to the damage seen in blood vessels within the retina.
Other eye conditions that can cause significant vision loss include cataracts (clouding of the lens), glaucoma (optic nerve damage), and age-related macular degeneration (deterioration of the central retina). Refractive disorders, such as astigmatism and farsightedness, which cause blurred vision, were also monitored.
Study Limitations and Implications
The study's authors noted that the cohort was nearly 98 percent male, so the findings may not be fully representative of women. Additionally, the average follow-up period of 4.6 years might be insufficient to detect the development of slower-progressing conditions like cataracts or macular degeneration.
Despite these limitations, the researchers emphasize that even a small increase in risk can affect a large number of people, given the prevalence of these eye conditions. Approximately 19 million Americans currently vape nicotine-containing e-cigarettes. They suggest that healthcare providers should discuss the potential eye risks associated with switching to vapes rather than quitting nicotine completely.