To determine whether there is an association between e-cigarette use and visual impairment
in the United States adult population.
Population survey study
1,173,646 adults ages 18 or older from all 50 United States and 3 U.S. territories
with self-reported responses to the CDC's 2016-2018 Behavioral Risk Factor Surveillance
System (BRFSS) annual telephone survey.
E-cigarette use (current, former, or never), assessed by the questions: “Have you
ever used an e-cigarette or other electronic vaping product, even just one time, in
your entire life?” and “Do you now use e-cigarettes or other electronic vaping products
every day, some days, or not at all?”
Main Outcome and Measure
Visual impairment, defined as a binary outcome “yes” or “no” to: “Are you blind or
do you have serious difficulty seeing, even when wearing glasses?”
After excluding missing data, there were 1,173,646 participants. The adjusted odds
ratio of visual impairment in current e-cigarette users compared to never e-cigarette users was 1.34 (95% CI, 1.20-1.48), and in former e-cigarette users was 1.14 (95% CI, 1.06-1.22)
In the subgroup of 662,033 never users of traditional cigarettes (weighted 59.6% of study population), the adjusted
odds ratio of visual impairment in current e-cigarette users compared to never e-cigarette users was 1.96 (95% CI, 1.48-2.61), and in former e-cigarette users was 1.02 (95% CI, 0.89-1.18).
Current compared to never e-cigarette usage was associated with a higher odds of visual impairment in the BRFSS
2016-2018 population, independent of traditional cigarette use.