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American Journal of Epidemiology 2005 162(1):73-79; doi:10.1093/aje/kwi168
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

Intensity of Smoking and Smoking Cessation in Relation to Risk of Cataract Extraction: A Prospective Study of Women

Birgitta Ejdervik Lindblad1,2, Niclas Håkansson1, Hanna Svensson3, Bo Philipson4 and Alicja Wolk1

1 Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
2 Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden
3 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
4 Stockholm Eye Clinic, H. M. Queen Sophia Hospital, Stockholm, Sweden

Correspondence to Dr. Birgitta Ejdervik Lindblad, Department of Ophthalmology, Sundsvall Hospital, SE-851 86 Sundsvall, Sweden (e-mail: birgitta.ejdervik.lindblad{at}swipnet.se).

The authors investigated the association of smoking and smoking cessation with the incidence of cataract extraction in a population-based prospective cohort study. A total of 34,595 women aged 49–83 years in the Swedish Mammography Cohort were followed from September 1997 through June 2002. Information on smoking, diet, and other lifestyle factors was collected through a self-administered questionnaire. A total of 2,128 cases of age-related cataract extraction were identified. Relative risks were estimated as rate ratios using Cox proportional hazards models. The authors observed a significant dose-response association between intensity of smoking and risk of cataract extraction (among current smokers, p for trend = 0.02; among past smokers, p for trend = 0.0002). After cessation of smoking, the risk decreased with time. Among women with a moderate lifetime smoking intensity (6–10 cigarettes/day), the relative risk was not significantly different from the risk among never smokers 10 years after smoking cessation. Among women who had smoked more intensively (>10 cigarettes/day), after 20 years of nonsmoking the increased risk became small and no longer statistically significant in comparison with never smokers (for trend over time, p < 0.0001). This prospective study confirmed smoking as a risk factor for cataract, with a dose response for smoking intensity. Smoking cessation predicts reduced risk over time, but a longer period of time is needed with a higher smoking intensity.

cataract; cohort studies; smoking; smoking cessation

Abbreviations: CI, confidence interval; RR, rate ratio.


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