title: Smoking and incidence of glaucoma: The SUN Cohort.
abstract: Smoking is a serious global public health concern that has been related to many chronic diseases. However, the effect of smoking on eye disorders has been less studied. The aim of this cohort study was to assess the association between current tobacco smokers and the risk of developing glaucoma and furthermore to evaluate the relationship between passive or former smokers and glaucoma.In this prospective and dynamic cohort, 16,797 participants initially who were found not to have glaucoma were followed up for a median of 8.5 years. Validated data on lifestyle, including tobacco consumption, were assessed at baseline. Information about new diagnosis of glaucoma was collected by follow-up questionnaires every 2 years. The outcome was the incidence of self-reported glaucoma during the follow-up. A subsample was used to validate the glaucoma diagnosis.During the 8.5 years of follow-up, 184 new glaucoma cases were identified. Current smokers had a significantly higher risk of glaucoma compared to participants who had never smoked after controlling for potential confounders (Hazard ratio [HR] 1.88 [95% coefficient interval (CI): 1.26-2.81]; P = 0.002). A nonsignificant increased risk was found among former smokers (HR 1.27 [95% CI: 0.88-1.82]; P = 0.198). When we assessed the exposure as per the number of cigarette pack-years, a dose-response relationship between pack-years and the risk of glaucoma was found (HR for the 5th quintile versus the 1st quintile: 1.70 [95% IC: 1.10-2.64], P for trend, 0.009). However, no relationship was found between passive smokers and glaucoma. (HR 0.67 [95% CI: 0.37-1.21]; P = 0.189).Our results suggest a direct association between current smokers and the incidence of glaucoma. In particular, this association was related to the number of pack-years, which was not found in the case of former smokers nor in the case of passive smokers.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid IdiSNA, Navarra Institute for Health Research Department of Ophthalmology, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Pérez-de-Arcelus
authors.forename: Estefanía
authors.initials: E
authors.lastname: Toledo
authors.forename: Miguel Á
authors.initials: MÁ
authors.lastname: Martínez-González
authors.forename: Nerea
authors.initials: N
authors.lastname: Martín-Calvo
authors.forename: Alejandro
authors.initials: A
authors.lastname: Fernández-Montero
authors.forename: Javier
authors.initials: J
authors.lastname: Moreno-Montañés
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution
chemical_list: D014028:Tobacco Smoke Pollution