association Between E-Cigarette Use and Visual Impairment in the United States.

Introduction:
This text summarizes a study on the association between e-cigarette use and visual impairment in the United States adult population. The study uses data from the Behavioral Risk Factor Surveillance System (BRFSS) survey from 2016-2018 and performs a cross-sectional analysis. The study controlled for various covariates such as traditional cigarette smoking, smokeless tobacco use, age, sex, race/ethnicity, marital status, education, employment status, family income, heavy alcohol use, body mass index, physical activity, and mental health.

Key Points:

* The study found an association between e-cigarette use and increased prevalence of visual impairment in the BRFSS population.
* Both e-cigarette use (current and former) and traditional cigarette use have statistically significant and independent associations with visual impairment.
* The subgroup analysis among never users of traditional cigarettes showed that current e-cigarette use had an independent association with perceived visual impairment.
* The subgroup analyses among current and former users of traditional cigarettes both showed that there was a small but significant association among e-cigarette use and perceived visual impairment.
* Younger age was associated with a higher odds of e-cigarette use, and greater age was associated with higher odds of visual impairment.
* The association of e-cigarette use on visual impairment was relatively consistent across age strata.
* There are proposed theories on the mechanism by which e-cigarettes may increase the likelihood of eye conditions that cause visual impairment, including increased symptomatic dry eye and decreased tear film quality.

Main Message:
The study found an association between e-cigarette use and increased prevalence of visual impairment in the BRFSS population. however, the study could not determine causation or temporal association between e-cigarette use and perceived visual impairment. additional longitudinal studies are warranted to investigate these findings. While a randomized clinical trial to study the effect of e-cigarette smoking on visual impairment is not feasible due to health and ethical concerns, a longitudinal observational study would be an alternative to further investigate this association.

Golla a, Chen a, Tseng VL, et al. association Between E-Cigarette Use and Visual Impairment in the United States. american journal of ophthalmology. 2022;235:229-240. doi:10.1016/j.ajo.2021.09.014