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An observational study published today in JAMA Ophthalmology has revealed that adolescents and young adults who engage in smoking and vaping are more likely to report various ocular problems, including dryness, redness, pain, blurry vision, light sensitivity, and headaches.
The study found that these eye-related symptoms were significantly more severe among young individuals who reported using both cigarettes and e-cigarettes compared to those who used only one of the products. These symptoms were particularly pronounced in those who had used both products in the past week.
Anne Xuan-Lan Nguyen, MDCM, an ophthalmology resident at the University of Toronto, Canada, who led the study, noted the increasing number of patients, especially adolescents and young adults, presenting with eye-related symptoms like dryness and irritation in ophthalmology clinics. Many of these patients did not use contact lenses or medications associated with eye problems but reported a history of using e-cigarettes and cigarettes. This observation led to her curiosity about the potential connection between smoking or vaping and ocular symptoms.
E-cigarettes have become the most popular tobacco product among young people, with a rising trend in both vaping and smoking known as dual use. Approximately 40% of middle and high school-aged tobacco users in the United States report using two or more tobacco products, according to the Centers for Disease Control and Prevention. While cigarette use has been linked to ocular damage, the effects of e-cigarettes on eyesight and their combined impact with cigarettes have been less understood.
The study surveyed over 4,000 individuals aged 13-24 about their tobacco product use in the past 30 days, the past 7 days, or ever. Results showed that 55.9% of those who had ever vaped also used cigarettes, and these dual users reported more severe and frequent eye symptoms compared to users of either product alone. Some dual users even reported daily, severe, or very severe ocular symptoms.
While e-cigarette use alone did not appear to be directly linked to eye problems, the survey revealed that users of vaping products were more concerned about their eye health compared to other participants. Those who smoked cigarettes only reported ocular symptoms, although not as severe or frequent as dual users.
The researchers hypothesize that ocular issues caused by both cigarettes and e-cigarettes could be attributed to oxidative damage. The combustion of cigarettes and the e-cigarette solvent (propylene glycol) may generate free radicals, leading to oxidative stress and damage to the ocular surface and film.
Laura Enyedi, MD, a pediatric ophthalmologist at the Duke Eye Center, emphasized the importance of considering smoking and vaping when addressing common complaints of dryness, redness, and burning in patients. While the observational nature of the study cannot confirm a causal relationship between dual use and ocular symptoms, it underscores the need to counsel against tobacco use among young people and provide cessation options.
Bonnie Halpern-Felsher, PhD, a professor of pediatrics at Stanford University and a co-author of the study, emphasized the significance of this research, aligning with numerous other studies highlighting the connection between smoking, e-cigarette use, and adverse health outcomes. The study received support from various organizations and institutes and disclosed potential financial conflicts of interest related to litigation against certain e-cigarette companies.
