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Jeffrey Ryuta Willis, Susanna S Park, Quoc-Anh Ho, Pradeep Y Ramulu; The Association of Smoking Status and Vision in U.S. Adults with Self-Reported Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3763.
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© ARVO (1962-2015); The Authors (2016-present)
Smoking is a modifiable risk factor for the progression of Age-related macular degeneration (AMD), but many adult Americans with AMD have difficulty quitting smoking. Fear of vision loss has been described as a predictor of smoking cessation, but little is known about the role of worsening objective visual acuity (VA) on smoking behavior. Here, we examine whether smoking cessation was more common among AMD patients with worse vision.
Cross-sectional study, utilizing data from the 2005-2008 National Health and Nutrition Examination Survey. Individuals, aged 40 years and older, self-reported whether they had been diagnosed with AMD during a household interview. Smoking history was also assessed, and having smoked ≥100 cigarettes in a lifetime was defined as a history of smoking. Among those with any history of smoking, a former smoker was currently smoking “not at all,” while a current smoker smoked “everyday” or “some days” at the time of the survey. Poor vision was defined as presenting VA (PVA) worse than 20/40 in the better eye. Multiple logistic regression analysis, adjusting for relevant confounders was conducted, where the main outcome variable was smoking cessation (operationalized as current vs. former smoker) and the main predictor for the model was logMAR PVA.
233 participants aged 40 and older with a self-reported diagnosis of AMD had complete data (80.6% of the eligible sample) and were eligible for analysis. Prevalence of any history of smoking among those with self-reported AMD was 50.5% (12.6% current smokers and 37.9% former smokers). Among those self-reported AMD patients that currently and formerly smoked, the prevalence of poor vision was 7.8% and 23.8%, respectively (p=0.16). In multivariate analysis, the odds of smoking cessation was 4.3 fold significantly greater per 0.3 logMAR unit increase in PVA [Odds Ratio 4.30, 95% Confidence Interval 1.93-9.55, p<0.01).
About one-half of adults with self-reported AMD in the US have a smoking history, and smoking cessation was more common among AMD patients with worse vision. Thus, smoking cessation in AMD patients may be happening late in the disease process, when the benefit of smoking cessation may not be optimal. Future research should prospectively assess the relationship between smoking cessation and vision in AMD patients.
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