Cigarette Smoking and Age Related Macular Degeneration

Published: December 1, 2021

Macular Degenearation

Some 34 million American adults smoke cigarettes, according to the American Cancer Society. Over the last several decades, smoking rates have declined, from 42% in 1965 to 14% in 2019. Still, tobacco use in the leading cause of preventable death in the U.S.(1)

Smoking increases the risk of cancers of the:

  • Lung
  • Mouth
  • Larynx (voice box)
  • Pharynx (throat)
  • Esophagus
  • Kidney
  • Cervix
  • Bladder
  • Pancreas
  • Stomach
  • Colon/rectum(1)

In addition, numerous studies have shown that smoking greatly increases the risk of developing Age Related Macular Degeneration (AMD). “In spite of the strength of this evidence, there appears to be a lack of awareness about the risks of developing eye disease from smoking among both healthcare professionals and the general public,” state researchers in a review article in Nature.(2)

There are a number of risk factors for AMD, several which are nonmodifiable, such as family history, age, race (caucasions are more prone to AMD than other groups). Cigarette smoking is a modifiable risk factor, along with high body mass index and alcohol use.(3) Smokers are twice as likely to develop AMD compared with nonsmokers, according to the Centers for Disease Control.(4)

The deterioration that marks AMD is caused by damage to the macula, the membrane at the center of the retina. “The damage occurs when an insulating layer between the retina and the blood vessels that nourish it breaks down resulting in fluid leaks and scarring.”(5) Researchers theorize that smoking may speed up this deterioration by increasing the amount of damaging chemical compounds and reducing the protective nutrients delivered to the eye via the bloodstream.(5) Second-hand smoke also increases risk for non-smokers, studies have shown. A study conducted at the University of Cambridge found that passive smoking exposure (defined as living with a smoker for five years or more) increased AMD risk for nonsmokers by a ratio of 1.87.(6)

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(1) American Cancer Society, Health Risks of Tobacco,

(2) J. Thornton, R. Edwards, P. Mitchell, et. al., Nature, Smoking and Age-Related Macular Degeneration, A Review of the Association,

(3) Veillilla, S., Garcia-Medina, J., Garcia-Layana, A., Journal of Ophthalmology, Smoking and Age-Related Macular Degeneration: Review and Update,

(4) Centers for Disease Control and Prevention, Vision Loss, Blindness, and Smoking,

(5) American Macular Degeneration Foundation, Don’t Smoke – It Exacerbates Eye Disease,

(6) Ophthalmology Times, Smoking Puts Patients at Risk for AMD,