Print Digg

Article

Smoking: A Call to Action

Friday, August 12, 2005


The untimely death of Peter Jennings from cigarette smoking related lung cancer suggests the need to discuss the increased risk factor for several eye diseases in those who smoke; including macular degeneration, glaucoma, cataract, diabetic retinopathy, optic neuropathy and neuritis, and dry eyes. Cigarette smoking is the single biggest preventable cause of death and disability in developed countries and it is one of our most significant public health concerns. The literature strongly suggests that ischemic, toxic, and oxidative effect of cigarette smoking plays an important role in damaging all ocular tissue.
 

Evidence from a large number of case-controled studies suggests that both current smoking and a history of smoking are associated with a higher risk of Age Related Macular Degeneration (AMD). Population based studies also support a strong association with cigarette smoking and the progression of dry AMD to neovascular (wet) AMD. Cigarette smoking is strongly suggested in the literature to alter choroidal blood flow and depress the ability of antioxidants to quench damaging free radical formation in the retina.
 

A meta-analysis of seven peer-reviewed studies published in the June 2004 issue of Public Health suggests that current cigarette smokers are also at significantly increased risk of developing primary open-angle glaucoma (POAG).
 

The July 2005 American Journal of Epidemiology published an alarming prospective study on women and cigarette smoking that suggests an increased risk factor for early cataract formation. Other studies suggest that current smokers of 20 or more cigarettes per day are at least twice as likely to develop any type of cataract and three times as likely to develop a particular type of cataract called posterior subcapsular cataract.
 
There appears to be a direct association between total cigarette consumption and the development of Graves Disease ( overactive thyroid gland which secretes too much thyroid hormone). When Graves' patients are smokers, they have nearly an eightfold-increased risk of developing serious eye complications compared with nonsmoking Graves' patients.
Smoking accelerates the development of eye complications and retinopathies associated with diabetes. A possible mechanism leading to damaged blood vessels in the diabetic eye is smoking-induced hypoxia.
 
It has recently been discovered that smoking is a significant risk factor for developing optic neuropathy, which can result in sudden, painless loss of vision, often leading to permanent blindness.
 

Peer-reviewed and published studies link changes in tear film proteins in dry eye patients who smoke cigarettes, as well as an elevation of neurotrophin levels in the tears of dry eye patients exposed to second hand smoke from cigarettes.
 
The July 2005 Morbidity and Mortality Weekley Report from the Center For Disease Control (CDC) calculated national estimates of annual smoking-attributable mortality (SAM), years of potential life lost (YPLL) for adults and infants, and productivity losses for adults. The findings indicated that between the years of 1997-2001, cigarette smoking and exposure to tobacco smoke resulted in 438,000 premature deaths in the United States, the loss of 5.5 million years of potential life, and the annual loss of 92 billion dollars in productivity. Recents CDC estimates are that 5 million people died world-wide from cigarette smoking in the year 2000. And that number is suggested to exceed10 million deaths a year by the year 2020 due to the billions of dollars spent on tobacco company ads that target our youth, as well as the lower socieoeconomic US population, third world countries, and particularly, Asia (the number of smokers under the age of 19 is now at an all time high). The chart below is taken from the CDC site and represents the current number of annual premature deaths from smoking vs. deaths from other causes.
 

 
Addendum: in response to this week's American Journal of Ophthalmology editorial on dietary supplements: Wouldn't it seem appropriate that CODEX and the people so determined to put nutritional supplements under the jurisdiction of the FDA, consider putting some of their passion and energy into the campaigns to prohibit cigarette advertising, since there are over 100,000 tobacco related deaths per year in this country alone and far more than 100.000 US deaths associated with the use and misuse of FDA approved pharmaceutical drugs, yet fewer than 25 deaths per year linked to the combined use or misuse of all dietary supplements?


Ellen Troyer, MT MA - Biosyntrx Chief Research Officer
Spencer Thornton, MD - Biosyntrx President.

PEARL

Two philosophical questions: 1) When does the greater good (that which does the most good for the largest number of people) supersede the legal obligations and rights of publicly traded companies to make profits for investors? 2) Is is realistic to expect pre-teens, teenagers and uneducated adults to make reasonable lifestyle choices while being targeted and romanced by multi-million dollar pro-smoking ad campaigns? Given the enormous amount of peer-reviewed literature that supports the loss of visual function, loss of life and loss of quality of life from cigarette smoking, isn’t it time that we the people, and the government agencies that we fund, declare our war of intent against all cigarette advertising in this country, since the number of premature deaths associated with cigarette smoking far exceeds the combined number of deaths in all of the Unites States wars, including the British American War, Indian Wars, Civil War, Spanish American War, World War 1, World War 2, Korean War, Vietnam War, and both Gulf Wars. Over 100,000 US citizens die prematurely each and every year and thousands of people become legally blind every year from cigarette smoking related diseases associated with legal tobacco addiction.

References

Annual smoking-sttributable mortality, years of potential life lost, and productivity losses--United States, 1997-2001. MMWR Morb Mortal Wkly Rep Centers for Disease Control and Prevention (CDC). 2005 Jul 1;54(25):625-9 [ abstract]

 

28,000 Cases of age related macular degeneration causing visual loss in people aged 75 years and above in the United Kingdom may be attributable to smoking. Evans JR, Fletcher AE. et al. Br J Ophthalmol. 2005 May:89(5):550-3 [ abstract]

 

Epidemiological association between cigarette smoking and primary open-angle glaucoma: a meta-analysis. Bonovan S, Filioussi K, Tsantes A, Peponis V, Public Health. 2004 Jun;118(4):256-61 [ abstract]

 

Intensity of smoking and smoking cessation in relation to risk of cataract extraction: a prospective study of women. Lindblad BF, Hakansson N, et al. Am J Epidemiol. 2005 Jul 1;162(1):73-9 [ abstract]

 

Smoking and its association with cataract; results of the Andhra Pradesh eye disease study from India. Krishnaiah S. Vilas K, et al. Invest Ophthalmol Vis Sci. 2005 Jan;46(1):58-65 [ abstract]

 

An update on medical management of Graves' ophthalmopathy. Bartalena L, Marcocci C. et al Journal Endocrinol Invest. 2005 May;28(5):469-78 [ abstract]

 

Smoking as an aetiological factor in a pedigree with Leber's hereditary optic neuropathy. Tsao K, Aitken PA, Johns DR. Br J Ophthalmol. 1999 May;83(5):577-81 [a bstract]

 

Effect of smoking on tear proteins. Grus F, Sabuncuo P, et al. Graefe's Archive for Clinical and Experimental Ophthalmology. 2002 Nov;240(1):889-92 [ abstract]

 

Passive smoking elevates neurotrophin levels in tears, Kiamata H, Human and Experimental Toxicoloty 2004 May;23(5);215-7 [abstract]

 

Defective visual field tests in chronic heavy smokers. Hepsen IF, Evereklioglu C. Acta Ophthalmol Scand. 2001 Feb;79(1):53-6 [abstract]