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Article
Friday Pearls
Smoking: A Call to Action
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.
