CIGARETTE-SMOKING AND THE RISK OF DEVELOPMENT OF LENS OPACITIES - THEFRAMINGHAM STUDIES

Objective: To examine the association between cigarette smoking and th e incidence of nuclear and nonnuclear lens opacities in members of the Framingham Eye Study Cohort. Participants and Methods: Eye examinatio ns were conducted on surviving members of the Framingham Heart Study C ohort from 1973 to 1975 (Framingham Eye Study I) and again from 1986 t o 1989 (Framingham Eye Study II). Smoking data, collected biennially s ince 1948 in the Heart Study, were used to examine the relationship be tween cigarette smoking and the incidence of lens opacities. Two thous and six hundred seventy-five persons were examined in the Framingham E ye Study I. Our analysis included 660 persons, aged 52 to 80 years, wh o were free of lens opacities at the first eye examination. Results: D uring the approximately 12.5 years between eye examinations, lens opac ities developed in a total of 381 persons, with nuclear opacities cons tituting the most frequent type. In logistic regression analyses that controlled for age, sex, education, and diabetes, a significant positi ve association with increasing duration of smoking and number of cigar ettes smoked daily was found for nuclear lens opacities, alone or in c ombination (test for trend, P less than or equal to.002), but not for nonnuclear opacities (test for trend, P=.62). Among the heavier smoker s (persons who smoked greater than or equal to 20 cigarettes per day a ccording to 6 or more biennial Framingham Heart Study examinations), 7 7% were still smoking at the time of the first eye examination. Person s who smoked 20 or more cigarettes per day at the time of the first ey e examination were at substantially increased risk for the development of nuclear opacities than nonsmokers (odds ratio, 2.84; 95% confidenc e interval, 1.46-5.51). There was no apparent excess risk for persons with nonnuclear lens opacities (odds ratio, 1.42; 95% confidence inter val, 0.65-3.07). Conclusion: This study provides further evidence that cigarette smokers have an increased risk of developing nuclear lens o pacities. The risk was greatest for heavier smokers, who tended to be current smokers and who smoked more cigarettes and for a longer durati on.