Smoking and AMD—Are E-Cigarettes the Answer?

by Dan Roberts

You’ve heard it before: “Tobacco Smoking Is A Major Cause Of Age Related Macular Degeneration”. According to most research, individuals 65 years of age and over double their risk of developing age-related macular degeneration (AMD) if they smoke. Why? Because tobacco smoking:

  • Reduces levels of plasma antioxidant, a substance in the blood stream that protects retinal cells.
  • Causes poor circulation, irritation and scarring in the retina.
  • Damages the blood supply.
  • Exposes the body to free radicals which causes cellular damage and poor circulation of nutrients to the retina and lens.
  • Substantially reduces carotenoid levels and vitamin C blood concentrations.
  • Oxidizes cholesterol, causing fat to build up in the arteries.*

But what if smokers enjoy their habit so much (or are so addicted that it is too difficult to quit) that they are willing to accept those risks, even it it means hastening vision loss and shortening life? Researchers are finding that such self-destruction may not be imminent after all. Public Health England has undergone an extensive study suggesting that smokers might safely continue satisfying their habit and their need for nicotine by substituting electronic cigarettes (ECs) for tobacco. The following information has been harvested from the lengthy report.
An EC is a cigarette-like device that uses battery power to heat an element to disperse a solution that usually contains nicotine. The dispersion of the solution leads to the creation of an aerosol that can be inhaled by the user. The heated solution typically contains propylene glycol or glycerine, water, nicotine, and flavorings. ECs do not contain tobacco, do not create smoke, and do not rely on combustion. Since EC emissions are technically an aerosol, the industry uses the terms vapor, vaping, and vaper. Even at the very high vapor density generated by the study procedure, the level of free radicals identified in vapor was “several orders of magnitude lower than in cigarette smoke”.

Since no smoke is inhaled, cell oxidation and all of the related health risks listed above are eliminated, leaving only the sought-after effects of nicotine. And inhaling nicotine by itself carries little or no health risk to either the vaper or bystanders. One drawback, however, is that ECs are slower than cigarettes at delivering nicotine. Cigarettes deliver nicotine very fast via the lungs. Although some EC products may already provide a degree of lung absorption, most nicotine is probably delivered via a much slower route through oral mucous membranes and upper airways. This is closer to the delivery from nicotine replacement medications than to the delivery from cigarettes. If EC continue to improve in the speed of nicotine delivery, they are likely to appeal to more smokers, making the switch from smoking to vaping easier.

In support of the benefits of vaping over tobacco smoking, a separate study that monitored asthma patients who switched from smoking to vaping found significant improvements in symptoms and in respiratory function. Further, a recent Cochrane Review found no significant adverse effects associated with EC use for up to 1.5 years. And finally, ECs have been found to be around 95% safer than tobacco cigarettes. Vaping may not be 100% safe, but most of the chemicals causing smoking-related disease are absent, and the chemicals that are present pose limited danger.

The authors of the Public Health England report suggest that smokers who switch to ECs will significantly reduce their risk of smoking related disease and death. This includes development of age-related macular degeneration. Those who will not or cannot break the habit may find comfort in knowing that there is a seemingly safe alternative.
*No Smoking by Linda Kaspari (published March 2006 online at
Download the complete report with supporting references:
E-cigarettes: an evidence update — A report commissioned by Public Health England. McNeill A, et al. (UK Centre for Tobacco & Alcohol Studies at Institute of Psychiatry, Psychology & Neuroscience, National Addiction Centre, King’s College London, and Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry Queen Mary, University of London.) Published August 2015.