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October 1997

Alcohol, Smoking, and CataractsThe Blue Mountains Eye Study

Author Affiliations

From the Department of Public Health and Community Medicine, University of Sydney (Dr Cumming); and the Department of Ophthalmology, Westmead Hospital and University of Sydney (Dr Mitchell), Sydney, Australia.

Arch Ophthalmol. 1997;115(10):1296-1303. doi:10.1001/archopht.1997.01100160466015

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 (≥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.