Cigarette smoking and thyroid eye disease: a systematic review

Area of Science:

• Ophthalmology
• Endocrinology
• Epidemiology

Background:

• Thyroid eye disease (TED) is an autoimmune condition affecting the eyes, often associated with Graves' disease.
• The role of tobacco smoking in the development and progression of TED has been debated.
• Understanding the causal link is crucial for patient education and management.

Purpose of the Study:

• To systematically review and evaluate the epidemiological evidence for a causal association between tobacco smoking and thyroid eye disease (TED).

Main Methods:

• Systematic review of published epidemiological studies.
• Quality assessment of included studies.
• Evaluation of evidence using established causality criteria.

Main Results:

• Fourteen papers (15 studies) were included, showing a positive association between smoking and TED.
• Case-control and cohort studies indicated increased risk and incidence of TED with smoking.
• Evidence suggests smoking is linked to poorer outcomes and disease progression in established TED.

Conclusions:

• Strong epidemiological evidence supports a causal association between smoking and the development of TED.
• Current smoking is linked to worse disease progression and treatment outcomes.
• Public and patient education on smoking risks for TED is essential, with support for smoking cessation recommended.