People who swap traditional cigarettes for electronic cigarettes may not be protecting their health as much as they think, according to new research that suggests vaping is linked to a higher risk of several major eye diseases compared with quitting nicotine altogether.
The study, conducted by researchers at Korea University College of Medicine in Seoul, analyzed health records from 179,273 adults enrolled in the Korean National Health Insurance Service. Participants were tracked for up to six years to examine whether different smoking cessation methods influenced long-term eye health.
Those who quit using all nicotine products experienced the lowest rate of eye disease, with 41.1 cases per 1,000 person-years, a standard measure that accounts for both the number of participants and the length of time they were followed.
Among people who gave up cigarettes but continued using alternative nicotine products, including electronic cigarettes, that figure increased to 44 cases per 1,000 person-years.
After accounting for other factors, researchers found that switching to smokeless nicotine products was associated with a 7% greater risk of developing major eye diseases than quitting nicotine entirely.
The largest increase was observed for diabetic retinopathy, a sight-threatening complication of diabetes that damages the small blood vessels in the retina. People who switched from smoking to vaping or other non-combustible nicotine products were 24% more likely to develop the condition than those who stopped using nicotine altogether.
Researchers also identified a 7% increase in the risk of refractive and accommodation disorders, which interfere with the eye’s ability to focus properly and can lead to blurred vision.
Although the findings point to a potential downside of replacing cigarettes with electronic nicotine products, the researchers stressed that the study cannot establish cause and effect. Because it relied on existing health insurance data rather than a randomized clinical trial, it can only identify an association between vaping and eye disease. In addition, participants’ smoking and vaping habits were based partly on self-reported questionnaires, which may be subject to inaccurate reporting.
Even with those limitations, the authors said the results suggest that switching to alternative nicotine products may not fully remove the health risks associated with smoking.
“These findings challenge the assumption that substituting NNTPs for CCs is visually harmless and indicate that, from an ophthalmic perspective, complete cessation of all nicotine products should remain the preferred cessation goal,” the researchers wrote.
Previous research has also linked vaping to respiratory disease, cardiovascular problems, inflammation, and potential effects on brain development, particularly in adolescents and young adults.
