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Mitigating the risks: addressing smoking cessation in thyroid eye disease.

Nasser Karimi1, Mohsen Bahmani Kashkouli2, Ali Keyhani1

  • 1Eye Research Center, Department of Ophthalmology, The Five Senses Health Institute, Moheb Kowsar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).

BMJ Open Ophthalmology
|September 1, 2025
PubMed
Summary

Verbal counselling effectively helps thyroid eye disease patients quit smoking, with nearly half succeeding. Varenicline showed limited success in those who didn't quit with counselling, due to poor adherence.

Keywords:
EpidemiologyEye (Globe)Eye LidsOcular surfaceOrbitProspective StudiesPublic healthTreatment Expectations

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Area of Science:

  • Ophthalmology
  • Endocrinology
  • Public Health

Background:

  • Thyroid eye disease (TED) is an autoimmune condition often linked to smoking.
  • Smoking cessation is crucial for managing TED and improving treatment outcomes.
  • Effective smoking cessation strategies are needed for patients with TED.

Purpose of the Study:

  • To evaluate the efficacy of verbal counselling and varenicline for smoking cessation in TED patients.
  • To identify factors predicting successful smoking cessation in this population.

Main Methods:

  • Cross-sectional analysis of the Iran TED (IrTED) Registry data.
  • Verbal cessation counselling provided routinely to active smokers.
  • Telephone survey to assess counselling effectiveness.
  • Prospective offer of varenicline to non-responders, assessing adherence and success.

Main Results:

  • 55.32% of TED patients in the database were non-smokers.
  • Among 73 active smokers receiving counselling, 49.01% successfully quit.
  • Varenicline was offered to 26 patients; only 7 attended prescription, and 1/3 completed treatment, quitting smoking.

Conclusions:

  • Verbal counselling is an effective first-line smoking cessation intervention for TED patients.
  • Varenicline demonstrated limited effectiveness, likely due to poor patient compliance and motivation.
  • Further research into improving adherence to pharmacotherapy in TED patients is warranted.