Abstract
Purpose :
The relationship between glaucoma, a leading cause of irreversible blindness globally, and smoking, a major modifiable health hazard, is uncertain. In this cross-sectional study, association between cigarette smoking and glaucoma in the civilian, non-institutional participants of the U.S. National Health and Nutritional Examination Survey (NHANES) and the Korea NHANES (KNHANES) was investigated.
Methods :
U.S. participants from 2005-2008 NHANES and Korean participants from 2008-2011 KNHANES who were ≥40 years of age and had visual fields and optic disc photographs were included. Participants with non-glaucomatous reason for either abnormal cup/disc ratio or visual fields were excluded. Glaucoma diagnosis was based on the Rotterdam criteria. Logistic regression modeling was performed to assess the association between glaucoma and smoking history, while controlling for age, sex, household income, alcohol consumption, refractive errors, body mass index, diabetes, and hypertension.
Results :
Glaucoma prevalence in the US sample was 5.5% (212/3864 subjects) and 7.8% in the Korean sample (1143/14608 subjects). In both populations, subjects with glaucoma compared to those without were older, likely to be male, and to have diabetes and hypertension. Korean subjects with glaucoma were also more likely to have less education, lower income, and greater alcohol consumption.
In the U.S., 54.7% glaucoma subjects were smokers while 50.7% non-glaucoma subjects were smokers (p=0.25). In Korea, 51.4% glaucoma subjects were smokers while 45.4% non-glaucoma subjects were smokers (p<0.001).
Among smokers, 34.2% Korean glaucoma subjects were current smokers while 32.2% non-glaucoma Korean subjects were current smokers (p<0.001). In the U.S., 30.2% glaucoma subjects were current smokers and 42.1% non-glaucoma subjects were current smokers (p=0.01).
The effect estimations of both non-smoker/smoker and current/ex-smoker comparisons were similar in adjusted models but neither had statistically significant differences.
Among smokers, greater pack/day of smoking history was associated with statistically significantly higher odds of glaucoma in the U.S. population (OR=1.70, 95%CI=1.08- 2.67, p=0.002), but not among Koreans.
Conclusions :
Smoking habit and exposure differ across populations and cultures. Cigarette smoking may be associated with higher odds of glaucoma in both the U.S. and in South Korea.
This is a 2021 ARVO Annual Meeting abstract.