The Effects of Smoking Tobacco on the Tissues of Eyes

Introduction

Smoking harms the bodily tissues of our body, in this essay I will be exploring the effects of smoking tobacco on the tissues of our eyes. Smoking has been associated with various eye conditions and vision defects including the development of age-related macular degeneration as smoking doubles the possibility of developing it. There are also links between smoking and the development of cataracts and the onset of diabetes-related sight problems. (RNIB, 2019)

It is useful to know what a cigarette Is composed of, so we can better understand what it is about smoking that harms us.

A cigarette contains chemicals that arise from different stages in the production process of a cigarette or during the use of a cigarette. Nicotine is an example of a chemical which is present in the tobacco plant itself. However, there are some chemicals that come from the fertilisers leeched into the soil from which the tobacco is grown some which are added when the tobacco leaves are desiccated and prepared and other chemicals only present themselves in the smoke of the burning leaves.

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Therefore, it is conclusive that chemicals present themselves throughout all the whole use and life of a cigarette.

Cigarettes components include Filters, which are made from thin fibres, designed to stop smoke from being inhaled however this is inefficient as the smoke is still inhaled. There are ventilation holes that dilute the smoke with air but can become ineffective when covered accidentally by fingers or lips. There is cigarette paper that holds the tobacco filler, which has added chemicals to control the speed of the cigarette burning, as the tobacco burns the paper burns with it and the smoke and chemicals that originate from the burning cigarette paper is also inhaled with the tobacco.

There is the Tobacco filler that will release chemicals when burned and there are hundreds of additives added to this to make smoking more appealing including sugars and flavour additives to make it easier and more pleasing to inhale. (US Food and Drug Administration, FDA, 2017)

AMD

AMD is a condition that affects central vision where it becomes blurry or distorted. Not all vision is lost, as you will still have peripheral vision. As we age, it increases our risk of developing AMD. (Macular Society) There are two types of AMD wet and dry. Wet AMD develops when blood vessels that are abnormal grow onto the macula, they leak blood and fluid which leads to scarring and loss of central vision as it Is the macula that provides central vision. It is the worse of the two types as it develops suddenly and not gradually like dry AMD. Treatment for wet AMD is now available such as anti-VEGF injections into the eye can be given to stunt the growth of these weak and abnormal blood vessels (RNIB, 2016)

Dry AMD is a slower deterioration of the cells of the macula and the retinal cells die off and are not restored. Symptoms of dry AMD include fading of colours, gaps in vision or straight edges such as a door frame may appear distorted or bent. Currently, there is no medical treatment for dry AMD but there is ongoing research for a cure. There have been some associations that diet can help slow the progression of dry AMD.

How is Smoking Related to AMD

Smoking is that the biggest modifiable risk issue for AMD. Exposing retinal cells to toxic chemicals and oxidants via the smoke in the air, and via the bloodstream fast forwards the progression of AMD. It inhibits the body's ability to protect itself. (Macular Society) Some of the toxic compounds in cigarette smoke are known to be either toxic or mutagenic. Ocular exposure to cigarette smoke can cause vascular changes and inflammation resulting in the cascade of AMD. Smoke also changes cells of the RPE in AMD patients (Roth F et al, 2004). Nicotine in the tobacco endorses angiogenesis, but these new blood vessels are weak and will leak fluid and blood causing scarring of the retina and AMD. Choroidal and retinal blood vessel epithelial tissue cells have nicotinic neurotransmitter receptors (nAChR), and nicotine enhances their proliferation, migration, and tube-forming ability. (Sarah Veillia, J Opthalmol, 2013)

Studies found: “A total of thirteen out of seventeen studies found a statistically important association between smoking and AMD with increased risk of AMD of two- to three-fold in current-smokers compared with never-smokers” (J Thornton et al, 2005)

The Rotterdam Study is a single-centre prospective study of the population aging over 55 years in Rotterdam (The Netherlands). A total number of 6251 participants were included from 1990 until 1993. Current- associate degreed former-smoking was related to an increased risk of neovascular AMD. This increased risk was up to twenty years once they stopped smoking. (Vingerling JR et al 1996)

Cataract

A cataract could be a vaporization of the lens within the eye that affects vision. According to the World Health Organization's (WHO) latest assessment, ARC is responsible for 51% of world blindness, which represents about 20 million people. Most cataracts are related to aging. (Waudby et al., 2011). It is caused by the compression of lens fibres into the centre of the lens, old fibres get stuffed into the middle of the lens. Risk factors of developing cataracts include diseases such as diabetes or environment, e.g overexposure to UV sunlight or behavioural factors such as smoking

Symptoms include cloudy/blurry vision, and faded colours, glare from headlights and the appearance of a halo around lights (Nei.nih.gov, 2015)

Treatment involves removing the lens and replacing it with an artificial plastic lens. This surgery is only done if the vision loss incurred by the cataract interferes with your everyday activities.

There have been studies to find out if and how smoking affects cataract development. In one study of 60 months, they found that Compared with never smokers, current smokers of 20 or more cigarettes per day had a statistically significant increase in the risk of cataract (relative risk [RR], 2.16 (Christen WG, 1992)

One study of 1705 people in South India found that Tobacco use was significantly associated with cataract: smoking was not found to be significantly associated with cataract formation however, smokeless tobacco use was more strongly associated with cataract. (Br J Ophthalmol. 2006)

Another study found that the cessation of smoking significantly decreased the risk for the need of cataract extraction with time. After more than 20 years since stopping smoking, men with a mean smoking intensity of more than 15 cigarettes per day had a 21% increased risk of a need of cataract extraction (Lindblad BE et al, JAMA Ophthalmology 2014)

Diabetes

Smoking will increase your cardiomyopathy risk as a diabetic due to each high levels of glucose within the blood. Smoking harm the walls of the arteries in such that fatty deposits can build up easier. As this happens, the blood vessels slender and makes the circulation of blood tougher. This blocks coronary arteries and might result in a heart attack.

Smoking may be a risk issue for non-diabetic individuals too, because it may be a issue for endocrine insulin resistance which may result in developing diabetes. (Diabetes.co.uk, 2016)

Rolled vs Manufactured

Finally, I would like to discuss whether self-rolled cigarettes are better than manufactured cigarettes. Many have the assumption that roll up cigarettes are better for you. But according to multiple sources, they are just as bad. Cancer Research UK says that roll-up tobacco cigarettes contain similar cancer-causing chemicals as factory-made cigarettes, thus aren’t any safer. (Cancer Research UK, 2018)

There are arguments that rolled up cigarettes are worse than manufactured cigarettes and this is because the tobacco is less compacted in rolled up cigarettes and therefore doesn't burn as easily, which leads to hotter combustion and more toxic smoke. 'You will have to take more intense drags to have your nicotine dose. The inhalation is both deeper and longer', explains tobaccologist Philippe Castera. (European Scientist, 2017)

In Conclusion, smoking increases your risk of developing eye conditions.

References

1. Waudby, C., Berg, R., Linneman, J., Rasmussen, L., Peissig, P., Chen, L. and McCarty, C. (2011). Cataract research using electronic health records. BMC Ophthalmology, 11(1).
2. Cancer Research UK. (2018). What’s in a cigarette?. [online] Available at: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/whats-in-a-cigarette-0 [Accessed 10 May 2019].