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Non-tobacco nicotine use and the risk of cataract development
Journal article   Peer reviewed

Non-tobacco nicotine use and the risk of cataract development

Nathan Vu Pham, Emery Dutta, Thalia H. Nguyen, Albert Y. Li, Amer Alsoudi and Asad Loya
Annals of epidemiology, v 121, 110146
01 Sep 2026
DOI: https://doi.org/10.1016/j.annepidem.2026.110146
PMID: 42269987
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Abstract

Cataract Cataract surgery Non-tobacco nicotine products Smoking Epidemiology
To examine the relationship between non-tobacco nicotine product (NTNP) exposure and the risk of cataract development and cataract surgery. A retrospective analysis of aggregated healthcare data within the TriNetX U.S. Collaborative Network We identified patients with documented exposure to NTNPs (n = 107,462) and control patients (n = 2,512,152) without exposure. NTNP exposure was defined as having had a vaping-related or unspecified nicotine dependence diagnosis. Patients with pre-existing lens disorders, ocular trauma, or procedures were excluded. Propensity score matching (1:1) was performed, accounting for demographics, cataract risk factors, and comorbidities. We assessed the risk of developing cataracts and receiving cataract surgery. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. After PSM, the exposure and control groups had mean ages of 50.8 ± 15.7 vs 51.8 ± 16.8 years, 61% vs 62% White, and 50% vs 50% female. Compared to matched controls (n = 106,116), patients exposed to NTNPs (n = 106,116) had an increased risk of developing cataracts (HR 2.21; 95% CI 2.12–2.31). Of the patients who received a cataract diagnosis, NTNP exposure was associated with higher risk of receiving cataract surgery (HR 2.93; 95% CI 2.77–3.09) within 5 years. NTNP usage may be associated with cataract development. Given their widespread use in recent years, they may pose considerable public health risks, and it would be prudent to further investigate their relationship with cataracts.

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