Dual E-Cigarette and Cigarette Use Worsens Dry Eye and Other Ocular Symptoms

Dual e-cigarette and cigarette users are at are at an elevated risk for experiencing frequent and severe ocular symptoms, which include dry eye, itching, redness, pain, and blurriness, according to research published in JAMA Ophthalmology. Ocular symptoms persist among these individuals regardless of the frequency of use, the report shows.

Researchers enrolled 4351 individuals (age range, 13-24 years; 63.8% women and girls) in an observational cross-sectional study and stratified participants according to smoking status. Among those included in the investigation, 2168 never used e-cigarettes, 2183 used e-cigarettes at some point in their lives, 1092 used e-cigarettes within the past 30 days, and 919 used e-cigarettes within the past 7 days. A total of 55.9% of study participants were dual e-cigarette and cigarette users. Study participants provided sociodemographic data and reported e-cigarette and cigarette usage, perceived vision quality, and the frequency and severity of their ocular symptoms. 

Dual e-cigarette and cigarette users were the most symptomatic — between 1.1% and 3.9% reported severe to very severe symptoms and between 0.9% and 4.3% reported daily symptoms. Individuals who used both products within the last 7 days experienced more severe itching (adjusted odds ratio [AOR], 2.37; 95% CI, 1.36-4.13; P =.002), redness (AOR, 2.58; 95% CI, 1.50-4.46; P =.001), dry eye (AOR, 2.89; 95% CI, 1.64-5.08; P <.001), glare (AOR, 2.56; 95% CI, 1.50-4.35; P = .001), blurriness (AOR, 2.47; 95% CI, 1.36-4.50; P = .003), headaches (AOR, 2.31; 95% CI, 1.34-4.00; P =.003) and more frequent pain (AOR, 3.45; 95% CI, 2.09-5.68; P < .001), burning (AOR, 3.08; 95% CI, 1.86-5.09; P < .001), and redness (AOR, 2.72; 95% CI, 1.69-4.36; P < .001) compared with all other participants. 

Dual use within the last 30 days resulted in more severe dry eye (AOR, 2.65; 95% CI, 1.61-4.36; P <.001) and more frequent pain (AOR, 3.33; 95% CI, 2.12-5.21; P < .001) compared with the remainder of the cohort. 

Participants with dual e-cigarette and cigarette use experienced more severe dry eye (AOR, 1.60; 95% CI, 1.05-2.43; P =.03) and blurriness (AOR, 1.79; 95% CI, 1.21-2.64; P =.003) and more frequent pain (AOR, 1.69; 95% CI, 1.13-2.53; P = .01) and blurriness (AOR, 1.63; 95% CI, 1.13-2.36; P = .009) compared with individuals who had never used either tobacco product.

“These findings provide additional reasons to screen, counsel, and treat all tobacco users to prevent and reduce ocular symptoms,” according to the study authors. “We recommend that health care clinicians ask all patients about nicotinic product use and counsel and treat those using these products to help prevent and reduce ophthalmologic issues.”

Study limitations include the cross-sectional design and potential self-reported bias.

This article originally appeared on Optometry Advisor