The Tear Film and Ocular Surface Society Lifestyle Workshop emphasised the need to identify modifiable risk factors to develop effective prevention strategies for dry eye disease (DED)1. Among these factors was smoking, including electronic cigarette (e-cigarette) use. While e-cigarettes may often be perceived as a safer alternative to conventional cigarettes, they are frequently linked to adverse health effects. Although there is substantial evidence connecting traditional smoking1 and smoke exposure2 to DED, data on the impact of e-cigarettes and their aerosols on DED are more limited.
In an invited commentary3, OSL team members Drs Michael Wang, Ceecee Britten-Jones (a postdoctoral researcher now based at the University of Melbourne) and Professor Jennifer Craig reviewed a recent study assessing ocular symptoms in adolescents and young adults using e-cigarettes, traditional cigarettes, or both4. The study found that dual use was associated with more frequent and severe dry eye symptoms. Despite a lack of detailed information on possible confounding factors and on dosage and frequency of use of the different smoking modes, the study highlights the concerning trend of increasing e-cigarette use among youth and underscores the urgent need for more research on their impact on ocular health.
Future research should ideally explore e-cigarette usage patterns, dosage and their interaction with conventional smoking to fully understand their effects on ocular health. In the meantime, caution continues to be advised as e-cigarette use looks unlikely to mitigate traditional smoking’s recognised side effects on the ocular surface and dry eye.
