New York (VINNEWS/Rabbi Yair Hoffman) Every month or so, I have an appointment with one of the top eye doctors in the New York area to deal with a repercussion of diabetes. What happens at that visit is not so pleasant. The treatment is a shot directly in the eye.

It is not a fun thing to go through. Yet skipping it is not an option. Without the shots, my eyes would further lose their ability to see. The doctor is a retina specialist, an expert in the back part of the eye.

This is why a new study on vaping and eyesight should grab everyone’s attention.

New Study: Electronic Cigarettes Harm Vision

New Study: Electronic Cigarettes Harm Vision

Many people think of switching to electronic cigarettes as the “clean” choice. The truth is more complicated. A large new study suggests that trading regular cigarettes for vapes still carries real risks for the eyes — and that the safest path is to give up nicotine entirely.

The research was published online on June 13 in the American Journal of Ophthalmology. It was led by Sangwook Cheon and Yihyun Kim of Korea University College of Medicine in Seoul, South Korea. Researchers analyzed health data from about 179,000 adults through the Korean National Health Insurance Service. Every person in the study had smoked regular cigarettes between 2011 and 2012, and all of them had quit smoking by 2018 or 2019.

The participants were sorted into two groups. One group stopped using all nicotine and tobacco products completely. The other group quit regular cigarettes but switched to smokeless products such as e-cigarettes. The researchers then followed both groups for an average of about four and a half years to see who developed eye disease.

During that time, there were 6,328 major eye disease events across the study. The people who quit nicotine entirely had the lowest disease rate, at 41.1 cases per 1,000 person-years. (A “person-year” is a way of counting that accounts for both the number of people and how long each was followed.) For the switchers, that rate rose to about 44 cases per 1,000 person-years.

The biggest jumps in risk showed up in two areas. The risk of diabetic retinopathy, a disease that damages the blood vessels of the retina, was about 24 percent higher in the switchers. The risk of refractive and focusing disorders was about 7 percent higher.

How Nicotine Hurts the Eye

Doctors explain that nicotine can squeeze blood vessels and make them narrower. When that happens, less blood flows through them. The retina is the light-sensing tissue at the back of the eye, and it depends on a delicate web of tiny blood vessels that are easily damaged. Diabetes can harm those same vessels, which is one reason the eye shots become necessary. Vaping can add to that same danger.

Specialists say nicotine can block proper blood flow, raise inflammation in the body, and add to other problems already tied to eye disease.

The results were clear. People who switched to vaping had a 7 percent higher chance of getting serious eye diseases. The biggest jump was in diseases that affect the blood vessels of the retina. That risk was 24 percent higher. Diabetes can damage those vessels as well, and that is why I need the shots.  Vaping would often cause a need for those shots as well.

Specialists said that nicotine can block proper blood flow, raise inflammation in the body, and add to other problems already tied to eye disease.

The researchers were careful to explain one important point. Not every person who vapes will get an eye problem. The study simply found that people who kept using nicotine had a greater chance of certain eye troubles than people who stopped completely.

The study does not say that regular cigarettes are safe. It says the safest choice for the eyes is to stop using nicotine altogether.

Experts who help people quit smoking added another warning. Many people see vaping as a step toward quitting. But vaping can keep a person hooked on nicotine and can also bring new substances into the body.

Diabetes and the Eyes

There is another major reason for these eye shots, and that reason is diabetes. High blood sugar over many years can damage the same tiny blood vessels in the retina. This condition is called diabetic retinopathy, and it is one of the leading causes of vision loss in adults.

When nicotine narrows the blood vessels and diabetes weakens them, the danger to the eyes grows even larger. Protecting eyesight means watching both at the same time — keeping blood sugar under control and staying away from nicotine.

The Six Mitzvos of Protecting Our Health

Avoiding clear dangers like these is not only smart. It is also a Torah obligation. In fact, there are six separate Mitzvos that apply to guarding our health and the health of those around us.

First, there is the Mitzvah of “veNishmartem me’od b’nafshosaichem” (Devarim 4:9) — the Mitzvah of guarding our health and well-being.

Second, the verse “Rak hishamer lecha” (Devarim 4:15) is understood by most Poskim to be an actual second Mitzvah (see Rav Chaim Kanievsky zt”l, Shaar HaTeshuvos #25) — to take special care of ourselves.

Third, there is the Mitzvah of “V’Chai Bahem — And you shall live by them” (Vayikra 18:5), which teaches us to choose actions that protect life.

Fourth, there is the Mitzvah found in “vahashaivoso lo — and you shall return it to him” (Devarim 22:2). The Gemara in Sanhedrin (73a) explains that this includes returning a person’s own life to him as well — the Mitzvah of saving a life, referred to in Shulchan Aruch, Orach Chaim 325.

Fifth, “Lo Saamod Al Dam Rayacha” — the negative Mitzvah of not standing by while your brother’s blood is in danger (Shulchan Aruch, Choshen Mishpat 426:1). This includes protecting yourself, your spouse, and your children too.

Sixth, “Lo Suchal l’hisalaym” — the negative commandment of “You cannot shut your eyes to it” (Devarim 22:3). The Netziv (HaEmek She’eilah) discusses this Mitzvah as well. Once we know of a real danger, we are not allowed to ignore it.

Vaping, diabetes, and other clear health risks touch on all six of these Mitzvos. Taking care of our eyes — and our whole body — is part of serving Hashem.

A Growing Body of Evidence

This new research joins a growing list of studies on the long-term effects of e-cigarettes. Some people who read the findings said it made them think twice about vaping. One former smoker said the research pushed him to look for a different way to quit. Others were not convinced and wondered whether money played a role in health warnings.

Doctors keep repeating two clear messages. People who do not smoke should never start using nicotine products. And no one should think of e-cigarettes as harmless.

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