"It is common knowledge that smoking is bad for your lungs, but did you know that it is also bad for your eyes? According to recent studies, smokers have double the risk of developing age-related macular degeneration (AMD), a loss of central vision, compared to those who do not smoke," says the article, "Smokers Not Able to See Through the Smoke."

"Quit smoking, save your sight."

The article, "Smoking, even second-hand, ups risk of eye disease," by Megan Rauscher (Reuters, 21 Dec 2005), says "Smoking puts you at increased risk of losing your sight in old age and the more you smoke the higher the risk," and "Smoking also increases the risk for the people living with you. So these are two good reasons to stop smoking," quoting Dr. John Yates of the University of Cambridge. See also the article, "Heavy Cigarette Smoking Increases Risk of Macular Degeneration - CME Teaching Brief," by Michael Smith (MedPage Today, 20 Dec 2005).

"Smokers have a twofold to threefold increased risk of developing age related macular degeneration with vision loss compared with those who have never smoked, say two studies reported in JAMA."

"Women smoking 25 or more cigarettes a day had 2.4 times the risk of developing the condition. Women with a history of smoking had a twofold increased risk of macular degeneration, with little drop in risk even in those who had stopped smoking more than 15 years before (JAMA 1996;276:1141-6)."

"Current smokers of 20 or more cigarettes a day had a twofold to threefold increased risk of developing the condition with vision loss compared with those who had never smoked."

"Those who smoked less than 20 a day were at no increased risk, while those with a history of smoking more than 20 cigarettes a day continued to have a 40% to 80% excess risk of age related macular degeneration for many years after stopping (JAMA 1996;276:1147-51)."

Above quoted from Zosia, Kmietowicz, "News: Smoke Does Get in Your Eyes," 313 British Medical J (#7062) 898 (12 Oct 1996).

"Smoking reduces blood supply by (1) vasospasm induced by nicotine, (2) atherosclotic narrowing of vessels, and (3) thrombotic occlusions. Vasospasm induced by smoking causes enlargement of the normal blind spot and reduced threshold of differential brightness. Visual perception is additionally depressed by the levels of carboxyhemoglobin commonly found in the blood of smokers, a hypoxic effect superimposed on the reduced blood supply. . . . Partial or complete blindness due to retinal artery thrombosis is at least twice as frequent in smokers as in nonsmokers. "—Samuel Zelman, M.D., "Correlation of Smoking History With Hearing Loss," 223 J Am Med Ass'n (8) 920 (19 Feb 1973).

See also "Smokers' blindness risk 'doubled' (6 September 2005), saying, e.g., "Smokers are twice as likely as non-smokers to lose their sight in later life, experts warn" and "Smoking is the only proven cause of AMD that people can do anything about," says Steve Winyard of the Royal National Institute of the Blind, etc.

An editorial, by Paul Mitchell, Simon Chapman, and Wayne Smith, "'Smoking is a major cause of blindness": A new cigarette pack warning?" 171 Med J Australia 173-174 (16 Aug 1999) has an excellent bibliography of recent writings on the subject.

A news article, "Blindness Risk for Smokers" by Julie Cush (The Evening Chronicle, 8 March 2004) says "Smokers are four times more likely to go blind than [nonsmokers]." She refers to the article by Simon P Kelly, Judith Thornton, Georgios Lyratzopoulos, Richard Edwards, and Paul Mitchell, "Smoking and blindness," 328 British Medical Journal (Issue # 7439) 537-538 (6 March 2004), saying that "smoking is associated with several eye diseases, including nuclear cataract and thyroid eye disease, the most common cause of smoking related blindness is age related macular degeneration, which results in severe irreversible loss of central vision," and that smokers have four times higher chance of macular degeneration, a progressive and irreversible condition, the leading cause of adult blindness. See also Dr. Robert Marin, UK public unaware smoking linked to vision loss.

         See also Johannes R Vingerling, Ida Dielemans, Jacqueline C M Witteman, Albert Hofman, Diederick E Grobbee, and Paulus T V M de Jong, Macular Degeneration and Early Menopause: A Case-control Study," 310 Brit Med J 1570-1571 (17 June 1995); and G. Leoz, "Alcohol-Nicotine Amblyopia," 9 Arch Soc oftal Hispano-Am 821-838 (Aug 1949).

           Why does tobacco have an adverse effect on vision? Answer: It contains vast quantities of toxic chemicals. Suggestion: read that site now, then come back to this one.

           It is because of tobacco's vast quantities of toxic chemicals that vision impairment results. The result is not an "accident," but is instead, a "natural and probable consequence."

           For example, due to those toxic chemicals, "the smoking of one cigarette . . . causes a definite contraction of the blood vessels in the retina of the eye. . . . nicotine is known to be one of the most poisonous substances known, an extremely small dose being sufficient to bring about its characteristic toxic effects. . . . . In recent years, Nueberg and associates have demonstrated the presence of toxic quantities of methyl or wood alcohol in cigarette smoke. Even though the amount of this substance inhaled daily is small, it is known to be cumulative in its action, so that even small quantities, repeatedly absorbed, may cause symptoms of blindness and partial blindness. It may be possible that this substance is a factor in the cause of the partial blindness which is so common in smokers."—Frank L. Wood, M.D., What You Should Know About Tobacco (Wichita, KS: The Wichita Publishing Co, 1944), p 65 (in discussion of tobacco ingredients starting at p 64).

Dr. Wood wrote in 1944. But the tobacco hazard to vision was being reported even earlier. Notice this material:

"The use of tobacco has a decided effect on the eyesight. Heavy smokers of tobacco almost invariably show some defect of the color fields, especially in the red and green. A central area in the field of vision will be blind to these two colors."—Daniel H. Kress, M.D., The Cigarette As A Physician Sees It (Mountain View, CA: Pacific Press Pub Ass'n, 1931), p 26.

And this material:

"Nicotine is a poison to the optic nerve or nerve of sight. Its continuous use during a long period of time often results in the production of blindness through destruction of the nerves of sight. This destruction is not complete, but lessens the efficiency of the eye to a marked degree by paralyzing the nerves of sight in such a way as to lessen the visual field. The condition of the visual fields is easily discovered by certain tests and is a highly valuable test for the effects of tobacco not only upon the nervous system, but of the body in general."

"Many authors report cataract of the eye in horses eating food containing tobacco seeds. This has been observed in Australia and in Virginia. Parsons and Pandi, also Walicka, have observed degeneration of the optic nerve. Langley and Anderson demonstrated the development of amblyopia in rabbits as the result of tobacco poisoning."

"McKenzie, one of the pioneers in the scientific treatment of diseases of the eye, so long ago as 1840, declared the use of tobacco to be ‘a frequent cause of amaurosis.'"

"Dr. Schweinitz names as the cause of amblyopia or axial neuritis, the use of tobacco and alcohol and states that of all substances, ‘ tobacco is the one most responsible.'

"The same author reports the case of a woman who did not smoke but who worked in a tobacco factory and who suffered from amblyopia (sudden blindness in this case). The patient quickly recovered after she left the factory."

"This form of blindness is most common in old smokers, those who have indulged fifteen years or more. Occasionally tobacco blindness develops in young smokers."

"According to Dr. Booth (Alienists and Neurologist, 1915) the use of tobacco is the most common of all causes of loss of sight and dimness of vision."—John Harvey Kellogg, M.D., LL.D., F.A.C.S., Tobaccoism or How Tobacco Kills (Battle Creek, MI: The Modern Medicine Publishing Co, 1922 and 1923), pp 92-93.

See also the material by

  • I. Newschueler, "Amblyopia Resulting from Smoking," 5 Lettura Oftal 399-429 (Sep 1928);

  • Dr. Harry M. Tarquair,"Tobacco Amblyopia," 2 Lancet 1173-1177 (8 Dec 1928);

  • Dr. Harry M. Tarquair, "Toxic amblyopia, including retrobulbar neuritis," 50 Trans Ophthalmol Soc U K 351 (1930);

  • H. Cohen, "Optic atrophy as a presenting sign in pernicious anemia," 2 Lancet 1202 (1936);

  • Dr. C. M. Culver (3 Sep 1882);

  • Dr. Albert L. Gihon (1881);

  • Charles R. Drysdale, M.D., F.R.S., Tobacco and the Diseases It Produces (London: Baillière, Tindall, and Cox, 1875), p 2;

  • the overview in Rev. John B. Wight's Tobacco: Its Use and Abuse (Columbia: L. L. Pickett Pub Co, 1889), pp 51-55;

  • Dr. Reuben D. Mussey's Health: Its Friends and Its Foes (Boston: Gould and Lincoln, 1862), pp 100-101 (reference to tobacco causing "occasional dimness or temporary loss of sight") and 126 (case example);

  • Drs. Irving Fisher and Eugene Fisk's How to Live, (New York: Funk & Wagnalls Co, 1915) p 352 ("Blindness or tobacco amblyopia, a form of neuritis, is not an uncommon affection among smokers. There is also often an irritant effect on the mucous membranes of eyes from the direct effect of the smoke.");

  • Dr. R. Brudenell Carter, "Alcohol and Tobacco," 250 Littell's Living Age 479, 490 (1906) ("with every other ophthalmic surgeon, I have now seen a great number of cases in which habitual smokers have suffered from a definite form of gradually increasing failure of vision, attended by characteristic symptoms dependent upon manifest changes in the optic nerves, and always curable, if taken in time, by the total abandonment of tobacco, but always leading to complete and hopeless blindness if tobacco in any form were continued"); and

  • the 'Surgeon-General-style' literature survey in Dr. Charles E. Slocum's About Tobacco and Its Deleterious Effects (Toledo, Ohio: The Slocum Publishing Co, 1909), pp 37-39.

          Actually, there were even earlier warnings. B. W. Chase in 1878 expressed concern about vision impairment from tobacco in these words: "Tobacco smoke not only irritates, but infuses poison to the injury of the nerve and muscles of the eye. When ammonia is taken into the nose it causes the tears to flow; so snuff causes the eyes to water. There are canals called lachrymal ducts, extending from the eyes to the cavities of the nose, with which the snuff comes in contact. Sooner or later the unnatural irritation thus caused will injure the nerve of vision."—Tobacco: Its Physical, Mental, Moral and Social Influences, by Rev. B. W. Chase, A.M. (New York: Wm. B. Mucklow Pub Co, 1878), pp 44-45.

Francis Dowling, E. W. Mitchell and P. Jenner, wrote "Symposium on Tobacco," in vol. 99, The Lancet-Clinic (Cincinnati) 699-706 (1908) (Section on "Tobacco and the Eyes," at 699-702), as the tobacco role in eye disease has long been known, in fact, even before these writers. Let's track this information back a bit further.

"Tobacco amblyopia, as a recognised disease, has an ancestry which dates from the year 1792, when attention was first drawn to it . . . . Mackenzie in 1833 laid much stress upon the fact." Prof. Dr. Hugh Percy Dunn, F.R.C.S. Eng., Ophthalmic Surgeon to the West London Hospital; Lecturer on Ophthalmology at the West London Post-Graduate College, cited this material to his students (while teaching them HOW to detect the condition) in his "Post-Graduate Lecture on Tobacco Amblyopia," 2 The Lancet (#4344) 1491-1493 (1 Dec 1906).

The 1792 reference is the date of the material on the subject by Dr. Joseph G. Beer, and his Lehre der Augenkrankheiten, Zweiter Theil, 66, Wien (1792).

Dr. Dowling's material on tobacco blindness was included in the lay work, The Tobacco Problem by Meta Lander (Boston: Lee and Shepard, 1882), p 178. Pages 178-179 thereof include reference to adverse impact of tobacco smoke on nonsmokers' vision.

"All our oculists are of one opinion, that the greatest enemy to the eyes of young men is the cigarette."—Theodore F. Frech, et al., The Evils of Tobacco and Cigarettes (Butler, Indiana: The Higley Printing Co, 1916), p 61.

You may think that data on tobacco's adverse effect in terms of vision deterioration being known that long ago is startling. But actually, even that observant doctor in 1792 wasn't the first to notice tobacco's adverse effects on the eyes. That honor goes to Dr. Tobias Venner (1577-1660), who observed this tobacco effect (among others) and thereupon reported it in his Via Recta ad Vitam Longam Whereunto is Annexed by the Same Author an Accurate Treatise Concerning Tobacco (London: J. Flesher, 1650). Yes, 1650, you read it right. See also Prof. Raymond Pearl, "Quotations: Tobias Venner and His Via Recta," 4 Human Biology (4) 558-583 (Baltimore, J. Hopkins Press, Dec 1932). (Dr. Pearl did a now-famous study on disproportionate smoker death rates).

Dr. C. H. Usher writing in "An Analysis of the Consumption of Tobacco and Alcohol in Cases of Tobacco Amblyopia," 2 Annals of Eugenics 245-261 (October 1927), provides a lengthy history of the medical writings on the subject. He did a thorough research job, a Surgeon General-type report, citing every known reference, for example, Dr. William MacKenzie's Treatise on Diseases of the Eye (London, 1830), p 835, citing a tobacco role in eye disease. Usher specifically included and listed Dr. Venner's 1650 material "written within 90 years of the introduction of tobacco into this country" around 1560.

Of course, as language has changed over the centuries, Dr. Venner did not use the 1920's term "Tobacco Amblyopia," he described the condition, and descriptions are understandable across centuries (after all, patients tell doctors descriptions, i.e., their symptoms; it is doctors who use whatever then is the current term for the description). In view of Dr. Venner's description of symptoms, Usher said that "it is quite possible that he was referring to those cases that are now called tobacco amblyopia." (Additional modern terms for tobacco related eye disorders are, for example, "macular degeneration" and "cataracts." Language is continuing to change; symptom patterns remain constant over the centuries).

         Tobacco has been repeatedly emphasized as THE controlling factor on the subject time and again. For example, see "Discussion on Toxic Amblyopia," 7 Transactions Ophthalmologic Society, United Kingdom 36 (1887), ruling out other factors (which the tobacco lobby and smokers want to cite, anything except to point the finger at the true cause).

For example, they like to pretend that this smokers' impaired vision is somehow seasonal or primarily alcohol-related! See, e.g., Usher, supra, and Cossu, "Ambliopia Alcoolico-nicotinica," Boll d'Oculist (1923) quoted in 11 Zentralbl. f. d. ges. Ophthalm 295 (1924) (finding incidence of cases to be highest and May and lowest in December; with the majority of patients seeking treatment during summer months). (Tobacco lobbyists and smokers muddle, for example, the time sequence, biological impact of the chemicals, cause and effect, disregarding the tobacco role in alcoholism.) The correct answer is of course that tobacco amblyopes see badly in bright light! So when more sunny days arrive, they think that's the problem! thus disregarding the underlying tobacco causation factor!

(Tobacco lobbyists and smokers so often seem to think that they—though never having studied the subject—know so much more than anybody and everybody in the medical profession!) (Do not overlook smoker mental disorder. "Smokers show the same attitude to tobacco as addicts to their drug, and their judgment is therefore biased in giving an opinion of its effect on them." Lennox Johnston, "Tobacco Smoking and Nicotine," 243 The Lancet 742 (19 Dec 1942).)

         The true incidence of the disease upon the visual nerve elements was in fact demonstrated in the medical profession many years ago. See

  • W. Mackenzie, A Practical treatise on Diseases of the Eye, 4th ed. (London: Longman, Brown, green, and Longmans, 1854), p 1067;

  • Bär, "Untersuchungen bei Tabak-Alkohol-Amblyopie," 54 Arch f Augenheilk 391 (1906);

  • Groenouw, "Über die Intoxicationsamblyopie," 38 Arch f Ophthalm 1 (1892);

  • Meta Lander, The Tobacco Problem (1882), pp 109-112;

  • J. Nelson, "On Tobacco Amblyopia," 2 British Medical Journal 774 (1880);

  • Chas. Shears, "Tobacco Amblyopia," Brit Med J (21 June 1884) (study of 40 cases, "Tobacco is the essential agent in producing the failure of sight.) (Abstracted in 8 Det Lancet (#7) 328 (Jan 1885);

  • Hirschberg, "Des amblyopies dues à l'alcool et au tabac," Soc. méd. psychol., de Berlin (4 March 1878) and Berl. Klin. Woch. (#3) (3 January 1879);

  • Nettleship, "Note sur le diagnostic de l'amblyopie par abus du tabac," IX Saint Thomas's hospital Rep 51 (1878), analyzed in Revue Hayem 651 (1878);

  • Wm. A. Alcott, M.D., The Use of Tobacco: Its Physical, Intellectual, and Moral Effects on The Human System (1836), pp 16-17 and p 77; and

  • Chemistry Prof. John I. D. Hinds, Ph.D., The Use of Tobacco (1882), p 102 (example effects listed: "dilatation of the pupils of the eye, confusion of vision, bright lines, luminous or cob-web specks, and long retention of images on the retina");

  • Dr. Abel Gy, L'Intoxication Par Le Tabac (Paris: Masson et Cie, 1913), pp 133-141.
  • And see recent references:

  • J. M. Heaton, A. J. A. McCormick, and A. G. Freeman, "Tobacco amblyopia: A clinical manifestation of vitamin B12 deficiency," 2 Lancet 286 (1958).

  • E. J. Watson-Williams, A. C. Bottomley, R. G. Ainley, and C. I. Philips, "Absorption of vitamin B12 in tobacco amblyopia," 53 Br J Ophthalmol 549 (1969)

  • M. Victor, "Tobacco amblyopia, cyanide poisoning and Vitamin B12 deficiency," in J. L. Smith, Neuroophthalmology (Hallendale, FL: Huffman, 1970), pp 33-48

  • A, M. Potts, "Tobacco amblyopia," 17 Surv Ophthalmol 313 (1973)

  • J. R. Samples and B. R. Younge, "Tobacco-alcohol amblyopia," 1 J Clin Neuro Ophthalmol 213 (1981)

  • J. F. Rizzo III, M.D., and Simmons Lessell, M.D., "Tobacco amblyopia," 116 Am J Ophthalmol (#1) 84-87 (July 1993)

  • David Mackey, M.D., and Neil Howell, Ph.D., "Tobacco amblyopia," 117 Am J Ophthalmol (#6) 817-819 (June 1994)

  • C Simon P Kelly, Richard Edwards, Peter Elton, and Paul Mitchell, "Smoking entails major risk of blindness," 326 Brit Med J (#7404) 1458-1459 (28 June 2003)
  •          One factor to note is due to smokers' addiction, mental disorder, and brain damage impairing reasoning, impulse and ethical controls, and the self-defense reflex. That factor is that:

    "Many tobacco amblyopes exhibit a striking absence of anxiety about their vision, which makes it difficult to get them to return for re-examination and makes them reluctant to stop their tobacco. Only in the most severe cases does the patient appear to be at all disturbed about his sight. I have persuaded some of these patients —often with some difficulty—to let me examine them again and have found them still smoking . . . ."—Dr. Harry M. Tarquair, "Tobacco Amblyopia," 2 Lancet 1173, 1176 (8 Dec 1928), supra.

             If this information is new to you, be aware of the rampant pro-tobacco media censorship. The media's wide-spread censorship of tobacco-facts, to the extreme of printing of gross disinformation, has been cited since at least 1930:

  • Charles M. Fillmore, Tobacco Taboo (Indianapolis: Meigs Pub Co, 1930), pp 88-89

  • Lennox Johnston, "Cure of Tobacco-Smoking," 263 The Lancet 480, 482 (6 September 1952); and

  • George Seldes, Never Tire of Protesting, (New York: Lyle Stuart Inc, 1968), Chapters 7-10, pp 61-99. (Seldes founded
  •          When rarely (as normally "the press has suppressed or withheld the facts concerning tobacco toxicity from the American people"), something is published, the material often goes unread as the tobacco taboo goes to the extreme of widespread refusal "even to read any book or article which refers to the harmfulness of tobacco . . . or in any other way exposes the evils of the drug."--Frank L. Wood, M.D., What You Should Know About Tobacco (Wichita, KS: The Wichita Publishing Co, 1944), pp 33 and 63. Our tobacco taboo website opposing pro-tobacco censorship has more details.

    Michigan's Solution:
    Banning Manufacture,
    Giveaway, and Sale
    of Cigarettes

    This ban was necessary to eliminate cigarette hazards as smoking involves long term ingestion of mind-altering toxic chemicals that impair smokers' reasoning and judgment, so they are generally rendered unable to recognize and react appropriately to the hazard.

    Wherefore our 1909 ancestors deemed warning labels ineffective and not a serious response to the hazard. In essence, they deemed labels a frivolous non-solution, as they disregard the fact that, pursuant to law, smoking is not a choice made via the normal "informed consent" process.

    Wherefore Michigan, pursuant to the turn-of-the century nonsmoker movement due to cigarettes' already then known hazards, in 1909, banned manufacture, giveaway, and sale of cigarettes by law as the only serious, real solution. It is typical consumer protection law, requiring that products be safe for their intended use.

    You may not think of macular degeneration as serious or fatal, but here is an example of how it is: a slip and fall down a flight of stairs, resulting in injury or even death.

    Dr. Harry M. Tarquair,"Tobacco Amblyopia," 2 Lancet 1173-1177 (8 Dec 1928), lamented the tragedies resulting from tobacco in these regards and more. He was writing in context of the fact that politicians generally were doing little or nothing to ban tobacco manufacture and sales, though they are willing to deal with many trivial matters wherein the resultant harm is ultra-small by contrast. He asked (rhetorically) if there is "any interest" in this "subject"?

    Sadly, the answer generally, 1650 to present, is still "NO." If you care, please write to your politicians asking for

  • a. a cigarette manufacture and sales ban like Iowa's of 1897, or

  • b. a cigarette sales ban like Tennessee's of 1897, or

  • c. a deleterious/adulterated cigarette manufacture and sales ban like Michigan's of 1909, and

  • d. prosecution pursuant to standard case law, of the manufacturers and sellers for the harm and deaths they have caused thus far.
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    Surgery Advisory Site

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