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. 2025 Feb 4;25(1):440.
doi: 10.1186/s12889-025-21573-2.

Global, regional, and national burden of blindness and vision loss attributable to smoking from 1990 to 2021, and forecasts to 2030: findings from the Global Burden of Disease Study 2021

Yi Zeng #  1   2   3   4 , Yixian Liu #  1   2   3   4 , Xingyi Chen  1   2   3   4 , Jennifer Kenny  1   2   3   4 , Rong Rong  5   6   7   8 , Xiaobo Xia  9   10   11   12
Affiliations

Global, regional, and national burden of blindness and vision loss attributable to smoking from 1990 to 2021, and forecasts to 2030: findings from the Global Burden of Disease Study 2021

Yi Zeng et al. BMC Public Health. .

Abstract

Objective: This study aims to systematically elucidate the burden of blindness and vision loss (BVL) attributable to smoking from 1990 to 2021 and to forecast the trends in BVL burden over the next decade.

Methods: We extracted data on years lived with disability (YLDs) and age-standardized YLDs rate (ASYR) related to blindness and vision loss (BVL) caused by smoking, including cataracts and age-related macular degeneration (AMD), from the Global Burden of Disease (GBD) database for the years 1990 to 2021. These data were disaggregated by age, gender, sociodemographic index (SDI), region, and country. Temporal trends in the burden of smoking-induced BVL were evaluated by calculating the average annual percentage changes (AAPCs).

Results: BVL attributable to smoking presents a significant disease burden, with global BVL-related YLDs attributable to smoking increasing from 1990 to 2021, while ASYR showed a declining trend. In 2021, the global BVL-related YLDs and ASYR attributable to smoking were estimated at 284.03 thousand and 3.27 per 100,000 population. The ASYR for cataract and AMD are 2.60 and 0.68 per 100,000, respectively. The burden was notably higher in males than females, highlighting significant gender disparities. Regionally, the highest burdens were observed in South Asia, Southeast Asia, and North Africa. It is expected that the number of global BVL-related YLDs will increase further by 2030.

Conclusion: Smoking has imposed a substantial disease burden on BVL over the past three decades. The burden is predominantly concentrated among males, particularly older individuals and those in low to middle-SDI regions. Moreover, the burden of smoking-induced BVL is expected to continue improving over the next decade.

Keywords: Blindness and vision loss; Global burden of disease; Risk factor analysis; Smoking.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
ASYR in 2021 (A-C) and AAPC of Smoking-attributable blindness and vision loss from 1990 to 2021 (D-F) in 204 Countries. (A, D) BVL; (B, E) Cataracts; (C, F) AMD
Fig. 2
Fig. 2
The relationship between SDI and ASYR of smoking-attributable BVL in different regions (A-C) and countries (D-F). (A, D) BVL; (B, E) Cataracts; (C, F) AMD. Areas above the curve represent a higher-than-expected burden, while areas below the curve represent a lower-than-expected burden
Fig. 3
Fig. 3
Distribution of smoking-attributable YLDs by gender, age group, SDI regions (A-C), and ASYR distribution across different age groups (D-F). (A, D) BVL; (B, E) Cataracts; (C, F) AMD
Fig. 4
Fig. 4
Trends in ASYR from 1990 to 2021. (A)BVL; (B)Cataracts; (C) AMD
Fig. 5
Fig. 5
SDI-related health inequality regression lines (A, B) and concentration curves (C, D) for ASYR and YLDs attributable to smoking-related BVL in 1990 and 2021
Fig. 6
Fig. 6
Distribution and projections of smoking-attributable YLDs (A-C) and ASYR (D-F) from 1990 to 2030. (A, D) BVL; (B, E) Cataracts; (C, F) AMD
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