A prospective study of cigarette smoking and age-related macular degeneration in women
Abstract
OBJECTIVE: To evaluate the relationship between cigarette smoking and incidence of age-related macular degeneration (AMD) among women. DESIGN: Prospective cohort study with 12 years of follow-up (1980 to 1992), in which information on smoking habits was updated every 2 years. SETTING: Eleven states throughout the United States. PARTICIPANTS: A total of 31 843 registered nurses enrolled in the Nurses' Health Study who were aged 50 to 59 years in 1980 and did not report a diagnosis of cancer or AMD at the beginning of the study. Additional women entered the analytic cohort as they reached 50 years of age. MAIN OUTCOME MEASURE: Incidence of AMD with visual loss. RESULTS: During 556 338 person-years of follow-up, 215 women were newly diagnosed as having AMD. After adjusting for other risk factors for AMD, women who currently smoked 25 or more cigarettes per day had a relative risk (RR) of AMD of 2.4 (95% confidence interval [CI], 1.4-4.0) compared with women who never smoked. Past smokers of this amount also had a 2-fold increased risk (RR=2.0; 95% CI, 1.2-3.4) relative to never smokers. Compared with current smokers, little reduction in risk was suggested even after quitting smoking for 15 or more years. Risk of AMD also increased with an increasing number of pack-years smoked (P for trend <.001); among women who smoked for 65 or more pack-years, the risk was 2.4 times the risk of never smokers (95% CI, 1.5-3.8). Analyses of dry and exudative types of AMD and other alternative definitions of AMD revealed similar results. CONCLUSIONS: Cigarette smoking is an independent and avoidable risk factor for AMD among women. Because AMD is the most common cause of severe visual impairment among the elderly and treatment is not available or is ineffective for most patients, reducing the risk of this disease is another important reason to avoid smoking.
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Cigarette smoking is a risk factor for age-related macular degeneration, confirmed by case-control, population-based, and prospective studies.
“Results from a number of case-control studies,28–33 population-based studies,34–36 and prospective studies of both physicians37 and nurses38 strongly confirm cigarette smoking as a risk factor for age-related macular degeneration.”
From Age-related macular degeneration (2008) · cites this paper as [37]
Cites
(1990) · Choice Reviews Online · doi:10.5860/choice.27-3338 · Cited by 35,305 · see citing works
Regression Models and Life-Tables
Cox, D. R. (1992) · Springer Series in Statistics · doi:10.1007/978-1-4612-4380-9_37 · Cited by 26,297 · see citing works
Reproducibility and validity of a semiquantitative food frequency questionnaire
WILLETT, W. C., SAMPSON, L., STAMPFER, M. J., ROSNER, B., BAIN, C., WITSCHI, J., HENNEKENS, C. H., & SPEIZER, F. E. (1985) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114086 · Cited by 4,274 · see citing works
Prevalence of age-related maculopathy
Klein, R., Klein, B. E. K., & Linton, K. L. P. (1992) · Ophthalmology · doi:10.1016/s0161-6420(92)31871-8 · Cited by 1,845 · see citing works
Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration
Seddon, J. M. (1994) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1994.03520180037032 · Cited by 993 · see citing works
Self-citationRelative and Absolute Excess Risks of Coronary Heart Disease among Women Who Smoke Cigarettes
Willett, W. C., Green, A. C., Stampfer, M. J., Speizer, F. E., Colditz, G. A., ROSNER, B. A., Monson, R. R., Stason, W. B., & Hennekens, C. H. (1987) · New England Journal of Medicine · doi:10.1056/nejm198711193172102 · Cited by 608 · see citing works
Senile macular degeneration: a case-control study
HYMAN, L. G., LILIENFELD, A. M., FERRIS, F. L., & FINE, S. L. (1983) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113629 · Cited by 587 · see citing works
Dietary fat and the risk of breast cancer.
Willett, W. C., Stampfer, M. J., Colditz, G. A., Rosner, B. A., Hennekens, C. H., & Speizer, F. E. (1987) · New England Journal of Medicine · doi:10.1056/nejm198701013160105 · Cited by 534 · see citing works
STRYKER, W. S., Kaplan, L. A., Stein, E. A., Stampfer, M. J., Sober, A. J., & Willett, W. C. (1988) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114804 · Cited by 520 · see citing works
Kahn, H. A., Leibowitz, H. M., Ganley, J. P., KINI, M. M., Colton, T., NICKERSON, R. S., & Dawber, T. R. (1977) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112429 · Cited by 391 · see citing works
Exposure to Sunlight and Other Risk Factors for Age-Related Macular Degeneration
West, S. K. (1989) · Archives of Ophthalmology · doi:10.1001/archopht.1989.01070010897038 · Cited by 262 · see citing works
Lower levels of vitamin C and carotenes in plasma of cigarette smokers.
Chow, C. K., Thacker, R. R., Changchit, C., Bridges, R. B., Rehm, S. R., Humble, J. W., & Turbek, J. A. (1986) · Journal of the American College of Nutrition · doi:10.1080/07315724.1986.10720134 · Cited by 200 · see citing works
A Prospective Study of Cigarette Smoking and Risk of Cataract Surgery in Women
Hankinson, S. E. (1992) · JAMA · doi:10.1001/jama.1992.03490080068026 · Cited by 154 · see citing works
Coffee Consumption and Coronary Heart Disease in Women
Willett, W. C. (1996) · JAMA · doi:10.1001/jama.1996.03530300042038 · Cited by 116 · see citing works
Bias in methods for deriving standardized morbidity ratio and attributable fraction estimates.
Greenland, S. (1984) · Statistics in Medicine · doi:10.1002/sim.4780030206 · Cited by 99 · see citing works
Willett, W. C., Hennekens, C. H., Castelli, W. P., ROSNER, B. A., Evans, D. A., Taylor, J., & Kass, E. H. (1983) · American Heart Journal · doi:10.1016/0002-8703(83)90358-7 · Cited by 92 · see citing works
The Effect of Cigarette Smoking on the Intraocular Circulation
Bettman, J. W., Fellows, V. G., & Chao, P. W. (1958) · Archives of Ophthalmology · doi:10.1001/archopht.1958.00940050037002 · Cited by 39 · see citing works
BLACKMAN, B. C., WHITE, P., Tsou, W., & FINKEL, D. (1984) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1984.tb13828.x · Cited by 20 · see citing works
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Cited by
Sorted by citations
Drusen proteome analysis: an approach to the etiology of age-related macular degeneration
Crabb, J. W., Miyagi, M., Gu, X., Shadrach, K., West, K. A., Sakaguchi, H., Kamei, M., Hasan, A., Yan, L., Rayborn, M. E., et al. (2002) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.222551899 · Cited by 1,208 · see citing works
The epidemiology of age-related macular degeneration
Klein, R., Peto, T., Bird, A., & Vannewkirk, M. R. (2004) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2003.11.069 · Cited by 932 · see citing works
Rivera, A., Fisher, S. A., Fritsche, L. G., Keilhauer, C. N., Lichtner, P., Meitinger, T., & Weber, B. H. F. (2005) · Human Molecular Genetics · doi:10.1093/hmg/ddi353 · Cited by 788 · see citing works
A Variant of the <i>HTRA1</i> Gene Increases Susceptibility to Age-Related Macular Degeneration
Yang, Z., Camp, N. J., Sun, H., Tong, Z., Gibbs, D., Cameron, D. J., Chen, H., Zhao, Y., Pearson, E., Li, X., et al. (2006) · Science · doi:10.1126/science.1133811 · Cited by 796 · see citing works
Oxidative damage-induced inflammation initiates age-related macular degeneration
Hollyfield, J. G., Bonilha, V. L., Rayborn, M. E., Yang, X., Shadrach, K. G., Lu, L., Ufret, R. L., Salomon, R. G., & Perez, V. L. (2008) · Nature Medicine · doi:10.1038/nm1709 · Cited by 710 · see citing works
Risk factors associated with age-related macular degeneration
(2000) · Ophthalmology · doi:10.1016/s0161-6420(00)00409-7 · Cited by 633 · see citing works
Risk factors for incident age-related macular degeneration
Tomany, S. C., Wang, J. J., van Leeuwen, R., Klein, R., Mitchell, P., Vingerling, J. R., Klein, B. E. K., Smith, W., & de Jong, P. T. V. M. (2004) · Ophthalmology · doi:10.1016/j.ophtha.2003.11.010 · Cited by 621 · see citing works
Holz, F. G., Bindewald-Wittich, A., Fleckenstein, M., Dreyhaupt, J., Scholl, H. P. N., & Schmitz-Valckenberg, S. (2007) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2006.11.041 · Cited by 619 · see citing works
Age-related macular degeneration
Coleman, H. R., Chan, C.-C., Ferris, F. L., & Chew, E. Y. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61759-6 · Cited by 542 · see citing works
Hypertension, cardiovascular disease, and age-related macular degeneration
Hyman, L. (2000) · Archives of Ophthalmology · doi:10.1001/archopht.118.3.351 · Cited by 441 · see citing works
Animal models of age related macular degeneration
Pennesi, M. E., Neuringer, M., & Courtney, R. J. (2012) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2012.06.003 · Cited by 391 · see citing works
Khan, J. C. (2006) · British Journal of Ophthalmology · doi:10.1136/bjo.2005.073643 · Cited by 390 · see citing works
Seddon, J. M. (2003) · Archives of Ophthalmology · doi:10.1001/archopht.121.12.1728 · Cited by 384 · see citing works
Self-citationAssociation between C-reactive protein and age-related macular degeneration
Seddon, J. M. (2004) · JAMA · doi:10.1001/jama.291.6.704 · Cited by 376 · see citing works
Self-citationProspective study of dietary fat and the risk of age-related macular degeneration
Cho, E., Hung, S., Willett, W. C., Spiegelman, D., Rimm, E. B., Seddon, J. M., Colditz, G. A., & Hankinson, S. E. (2001) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/73.2.209 · Cited by 350 · see citing works
Self-citationAssociation of CFH Y402H and LOC387715 A69S with progression of age-related macular degeneration
Seddon, J. M., Francis, P. J., George, S., Schultz, D. W., Rosner, B., & Klein, M. L. (2007) · JAMA · doi:10.1001/jama.297.16.1793 · Cited by 330 · see citing works
Self-citationFamilial aggregation of age-related maculopathy
SEDDON, J. M., AJANI, U. A., & MITCHELL, B. D. (1997) · American Journal of Ophthalmology · doi:10.1016/s0002-9394(14)71036-0 · Cited by 350 · see citing works
Self-citationSeddon, J. M., Reynolds, R., Maller, J., Fagerness, J. A., Daly, M. J., & Rosner, B. (2009) · Investigative Opthalmology & Visual Science · doi:10.1167/iovs.08-3064 · Cited by 285 · see citing works
Self-citationDelcourt, C., Michel, F., Colvez, A., Lacroux, A., Delage, M., & Vernet, M.-H. (2001) · Ophthalmic Epidemiology · doi:10.1076/opep.8.4.237.1613 · Cited by 241 · see citing works
Cigarette Smoking and Age-Related Macular Degeneration in the EUREYE Study
Chakravarthy, U., Augood, C., Bentham, G. C., de Jong, P. T. V. M., Rahu, M., Seland, J., Soubrane, G., Tomazzoli, L., Topouzis, F., Vingerling, J. R., et al. (2007) · Ophthalmology · doi:10.1016/j.ophtha.2006.09.022 · Cited by 230 · see citing works
Schmidt-Erfurth, U., Waldstein, S. M., Deak, G.-G., Kundi, M., & Simader, C. (2015) · Ophthalmology · doi:10.1016/j.ophtha.2014.11.017 · Cited by 211 · see citing works
Seddon, J. M., Santangelo, S. L., Book, K., Chong, S., & Cote, J. (2003) · The American Journal of Human Genetics · doi:10.1086/378505 · Cited by 208 · see citing works
Self-citationSeddon, J. M., Reynolds, R., Yu, Y., Daly, M. J., & Rosner, B. (2011) · Ophthalmology · doi:10.1016/j.ophtha.2011.04.029 · Cited by 198 · see citing works
Self-citationWeeks, D. E., Conley, Y. P., Tsai, H.-J., Mah, T. S., Schmidt, S., Postel, E. A., Agarwal, A., Haines, J. L., Pericak-Vance, M. A., Rosenfeld, P. J., et al. (2004) · The American Journal of Human Genetics · doi:10.1086/422476 · Cited by 195 · see citing works
Is Age-related Maculopathy Associated with Alzheimer's Disease?: The Rotterdam Study
Klaver, C. C. W., Ott, A., Hofman, A., Assink, J. J. M., Breteler, M. M. B., & de Jong, P. T. V. M. (1999) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a010105 · Cited by 162 · see citing works
Biomarkers of Cardiovascular Disease as Risk Factors for Age-Related Macular Degeneration
Vine, A. K., Stader, J., Branham, K., Musch, D. C., & Swaroop, A. (2005) · Ophthalmology · doi:10.1016/j.ophtha.2005.07.004 · Cited by 160 · see citing works
Dietary ω-3 Fatty Acid and Fish Intake and Incident Age-Related Macular Degeneration in Women
Christen, W. G. (2011) · Archives of Ophthalmology · doi:10.1001/archophthalmol.2011.34 · Cited by 138 · see citing works
Ebrahem, Q., Renganathan, K., Sears, J., Vasanji, A., Gu, X., Lu, L., Salomon, R. G., Crabb, J. W., & Anand-Apte, B. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0601552103 · Cited by 117 · see citing works
Chong, E. W.-T., Kreis, A. J., Wong, T. Y., Simpson, J. A., & Guymer, R. H. (2008) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2007.12.005 · Cited by 112 · see citing works
Prospective Study of Alcohol Consumption and the Risk of Age-Related Macular Degeneration
Cho, E. (2000) · Archives of Ophthalmology · doi:10.1001/archopht.118.5.681 · Cited by 102 · see citing works
Nischler, C., Oberkofler, H., Ortner, C., Paikl, D., Riha, W., Lang, N., Patsch, W., & Egger, S. F. (2011) · Acta Ophthalmologica · doi:10.1111/j.1755-3768.2010.02080.x · Cited by 81 · see citing works
Wu, J., Cho, E., Giovannucci, E. L., Rosner, B. A., Sastry, S. M., Willett, W. C., & Schaumberg, D. A. (2017) · Ophthalmology · doi:10.1016/j.ophtha.2016.12.033 · Cited by 74 · see citing works
“Our case definition has been previously described(19) and also validated by comparison with retinal images and medical records.(20) Briefly, when a participant reported a diagnosis of AMD on a biennial questionnaire, we requested informed consent and then contacted the participant’s eye doctor to confirm the diagnosis…”
Neuner, B., Komm, A., Wellmann, J., Dietzel, M., Pauleikhoff, D., Walter, J., Busch, M., & Hense, H.-W. (2009) · Addictive Behaviors · doi:10.1016/j.addbeh.2009.05.015 · Cited by 46 · see citing works
Peroxisome proliferator-activated receptor and age-related macular degeneration
Herzlich, A. A., Tuo, J., & Chan, C.-C. (2008) · PPAR Research · doi:10.1155/2008/389507 · Cited by 43 · see citing works
Molecular Genetics of Age-Related Macular Degeneration: Current Status
Allikmets, R. (1999) · European Journal of Ophthalmology · doi:10.1177/112067219900900401 · Cited by 29 · see citing works
Risk Factors for Age-Related Maculopathy: The Visual Impairment Project
McCarty, C. A. (2001) · Archives of Ophthalmology · doi:10.1001/archopht.119.10.1455 · Cited by 12 · see citing works
- Authors
- Seddon, J. M.
- Affiliations
- Massachusetts Eye and Ear Infirmary (US)
- Corresponding author
- Seddon, Johanna M.
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1996-10-09
- Volume
- 276
- Issue
- 14
- Pages
- 1141
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2033902287
- Cited by
- 435
- References
- 18
- Citations by year
- 2026: 7 · 2025: 21 · 2024: 10 · 2023: 10 · 2022: 10 · 2021: 22 · 2020: 16 · 2019: 9 · 2018: 12 · 2017: 12 · 2016: 10 · 2015: 25 · 2014: 19 · 2013: 17 · 2012: 20
- FWCI
- 16.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Eye Institute (R01EY009611, EY09611)
- National Cancer Institute (CA-40356)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Keywords
- cigarette smoking, age-related macular degeneration, women, risk factors, pack-years, smoking cessation, vision loss, Nurses' Health Study, neovascular age-related macular degeneration, dry age-related macular degeneration
- MeSH terms
- Female, Follow-Up Studies, Humans, Macular Degeneration, Middle Aged, Prospective Studies, Risk Factors, Smoking, Cohort Studies, Incidence, Multivariate Analysis
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