Alcohol, smoking, and cataracts: the Blue Mountains Eye Study
R. G. Cumming and P. Mitchell
Department of Public Health and Community Medicine, University of Sydney, NSW, Australia.
OBJECTIVE: To investigate the associations between alcohol consumption,
tobacco smoking, and cataract. DESIGN: A population-based, cross-sectional
study. SETTING: An urban community in the Blue Mountains, close to Sydney,
Australia. PARTICIPANTS: Three thousand six hundred fifty-four people aged
49 to 97 years. The participation rate was 82%. MAIN OUTCOME MEASURES:
Smoking history and details of current alcohol consumption were assessed by
questionnaire. Lens photographs were taken and graded for presence and
severity of cortical, nuclear, and posterior subcapsular cataracts.
RESULTS: After adjusting for multiple potential confounders, people who had
ever smoked cigarettes had a higher prevalence than nonsmokers of more
severe nuclear (adjusted odds ratio [OR], 1.3; 95% confidence interval
[CI], 1.1-1.6) and posterior subcapsular (adjusted OR, 1.5; 95% CI,
1.1-2.1) cataracts. The association between pipe smoking and nuclear
cataract (adjusted OR, 3.1; 95% CI, 1.5-8.2) was stronger than the
association with cigarette smoking. Alcohol consumption was associated with
a reduced prevalence of cortical cataract: compared with people who did not
drink, the adjusted OR for cortical cataract among people who drank at
least 1 drink a day was 0.7 (95% CI, 0.6-0.9). Heavy alcohol consumption
(> or =4 drinks a day) was associated with nuclear cataract in current
smokers (adjusted OR compared with nondrinkers, 3.9; 95% CI, 0.9-16.6) but
not in never smokers. CONCLUSIONS: Consistent with other studies, smoking
was associated with a higher prevalence of nuclear and posterior
subcapsular cataracts. The only adverse effect of alcohol was among
smokers: people who smoked and drank heavily had an increased prevalence of
nuclear cataract.
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