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Quitting smoking may lower long-term cataract risk

By Kathryn Doyle

NEW YORK (Reuters Health) - Smoking raises the risk of developing cataracts, but quitting may turn that around over time, according to a new study from Sweden.

Researchers followed nearly 45,000 Swedish men and found a gradual drop in cataract risk among former smokers - 20 years after quitting, their risk had fallen by about half.

"This (adds) to the imperative that we have in counseling people," said Dr. Anat Galor, who was not involved in the study.

There was already good data that smoking and eye problems like cataract . . . could be related to smoking, she told Reuters Health. But this is one of the first studies to investigate whether quitting smoking makes a difference.

"We have previously investigated the association with smoking cessation and cataract extraction among 35,000 women in Sweden aged 49-83 years," Dr. Birgitta Ejdervik Lindblad told Reuters Health in an email.

"Among women who smoked 6 to 10 cigarettes per day the relative risk of cataract extraction decreased with time and the risk was not significantly different from the risk among never smokers 10 years after smoking cessation," said Lindblad, who led the new study at Örebro University Hospital.

But for women who smoked more, it took 20 years before cataract risk was no longer greater than for women who had never smoked, Linblad added.

To see whether the same held true for men, she and her team followed the middle aged and older men participating in a larger study through surveys and surgery records.

Between 1997 and 2009, the men had more than 5,700 cataract removals.

Men who currently smoked more than 15 cigarettes a day had a 42 percent greater risk of having cataract surgery than men who had never smoked, according to the results published in JAMA Ophthalmology.

More than 20 years after quitting, however, men who had smoked at that rate were at 20 percent greater risk for cataract removal compared to men who never smoked.

For men who had been lighter smokers, the increased risk of cataract fell more quickly after quitting, but never reached the level of those who had never smoked.

These results aren't very surprising, but they are useful, especially for eye doctors, said Galor, an assistant professor of Clinical Ophthalmology at the Bascom Palmer Eye Institute in Miami.

Patients tend to value vision more than many other faculties, she said. "You can talk about cancer and death, but if you tell a patient they are going to go blind, that tends to have more of an effect," she said.

Anti-smoking campaigns in Australia that feature vision risks have been very successful, she noted.

Primary care doctors may not have eye problems at the top of their lists of things to look out for with patients who smoke, Galor said. But ophthalmologists are in a special position to counsel patients and should always remember to ask about smoking status.

"Maybe the general internist isn't thinking about this," Galor said. "The ophthalmologist can be an effective advocate for smoking cessation."

"It is never too late to stop smoking, but it takes a longer time for the lens to recover with higher smoking intensity," Lindblad said. "Smoking is increasing worldwide and health professionals and ophthalmologists should encourage people to stop smoking, or better never start to smoke."

SOURCE: http://bit.ly/198QLVU JAMA Ophthalmology, online January 2, 2013.

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