CLAIM:
Smoking significantly increases the risk of developing cataracts at an early age. An unhealthy lifestyle, along with factors such as excessive sun exposure, diabetes, and genetic predisposition, can accelerate early-onset cataracts, especially among younger people.
FACT:
Smoking is a well-established risk factor for cataracts in general, but current scientific evidence does not conclusively prove that it directly causes early-onset cataracts. Large studies show no significant difference in early cataract risk between smokers and non-smokers. According to experts, proven causes of early cataracts include genetic predisposition, long-term steroid use, uncontrolled diabetes, eye injury, and chronic eye inflammation.
In a viral Instagram reel posted by Ranveer Allahbadia, popularly known as BeerBiceps, addresses the link between smoking and early cataracts.
The clip is from his podcast series, which he describes as a space where “every episode has been designed to bring you some kind of value adds,” with conversations centred on health, lifestyle, and self-improvement.
In the reel, Ranveer is seen in conversation with Dr Rahil Chaudhary, an ophthalmologist, as he asks what he calls a crucial question around declining eye health among younger generations. Raising concerns about early-onset cataracts, Ranveer asks what could be driving this trend.
Responding to the question, Dr Chaudhary points to smoking as a major risk factor. “Smoking is one of the biggest reasons for early cataract,” he says, adding that excessive exposure to sunlight also contributes significantly to the condition.
Taking the conversation further, Ranveer asks whether today’s Gen Z and millennials should be worried about developing cataracts early in life. Dr Chaudhary responds candidly, warning that lifestyle choices play a critical role. He explains that an unhealthy lifestyle can accelerate the onset of cataracts, and adds that diabetes is another important risk factor. He also notes that cataracts can be genetically determined, making some individuals more susceptible than others.
Does smoking cause early cataracts?
If we first look at the broader association between smoking and cataracts, medical evidence is consistent - smoking increases the overall risk of developing cataracts.
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A cataract refers to the clouding of the eye’s lens, which is normally clear. This clouding blocks light from passing through to the retina, leading to gradual vision loss. Cataracts usually develop slowly over several years, and advancing age remains the strongest risk factor. Smoking, however, further increases this risk.
According to the U.S. Food and Drug Administration (FDA), “Smoking cigarettes can cause cataracts. People who smoke cigarettes are two to three times more likely to develop cataracts than people who don’t smoke.” The FDA notes that smokers may not notice symptoms initially, but as cataracts worsen, they can significantly impair vision.
What does research say about smoking and cataract risk?
Strong evidence supporting this association comes from a large 2014 prospective cohort study conducted in Sweden. The study followed 44,371 men aged 45–79 years from the Cohort of Swedish Men over a 12-year period, tracking incident cases of age-related cataract extraction through national surgical registers.
The researchers found that smoking intensity and cumulative exposure were strongly associated with cataract risk. Current smokers consuming more than 15 cigarettes a day had a 42 per cent higher risk of cataract extraction compared to never-smokers.
Importantly, the study also showed that quitting smoking reduced the risk over time, although the elevated risk persisted for decades, especially among heavy smokers.
The authors concluded that “smoking cessation seems to decrease the risk of cataract extraction with time, although the risk persists for decades,” emphasising the importance of early cessation and, ideally, avoiding smoking altogether.
More recently, a 2025 population-based study from Sweden examined both the prevalence of cataracts and the incidence of cataract surgery in relation to smoking. Analysing data from over 9,300 participants, researchers found that people who had ever smoked had a significantly higher prevalence of self-reported cataracts and cataract surgery compared to never-smokers. Current and former smokers also had a higher risk of undergoing cataract surgery, demonstrating a dose–response relationship with years of smoking.
But does smoking cause early-onset cataracts?
While the evidence linking smoking to cataracts in general is strong, the picture becomes less clear when the focus shifts to early-onset cataracts.
A large prospective Australian cohort study specifically examined whether smoking increased the risk of cataract surgery before the age of 65. The study followed 70,886 participants aged 45–55 years and identified early-onset cataracts through linked Medicare records.
Although individuals with early-onset cataracts showed longer smoking duration or higher smoking intensity in certain sub-groups, the researchers found no statistically significant difference in early-onset cataract risk between current smokers, former smokers, and never-smokers after adjusting for confounding factors.
The authors concluded that “smoking has neither a beneficial nor harmful effect on the long-term incidence of early-onset cataracts.”
Similar findings emerged from a 2024 clinical study analysing electronic medical records of 718 patients aged 40–65 years who underwent cataract surgery. Researchers found no significant difference in the age of cataract surgery between smokers and non-smokers, even after controlling for diabetes and hypertension. Smoking intensity and smoking status also showed no association with earlier surgery.
The study concluded that “no significant associations were found,” and called for further research to better understand whether smoking plays any role in triggering cataracts at a younger age.
In a nutshell, while smoking remains a well-established risk factor for age-related cataracts, its role in triggering cataracts earlier in life appears less certain, highlighting the need for more targeted research on early-onset disease.
What do the experts say?
Dr Uma Mallaiah, Ophthalmologist at Indraprastha Apollo Hospitals, New Delhi, with over 28 years of clinical experience, said that past research has shown “an association or a link between smoking and cataracts,” but clarified that “it is not proven that smoking actually causes cataracts.”
Emphasising the difference between causation and risk, she noted, “It’s not that because you smoke, you will get cataracts. Smoking is considered a risk factor, just like diabetes is a risk factor, but that does not mean everyone with diabetes or everyone who smokes will develop cataracts.”
Dr Mallaiah added that the exact reason why some people develop cataracts earlier than others remains unclear. “Nobody really knows why certain people get cataracts while others don’t,” she said, pointing instead to genetics as a strong underlying influence. “What is definitely true is that there is a genetic predisposition. Cataracts tend to run in families.”
Explaining this variability, she said that in some families cataracts appear in the early 60s, while in others they develop much later, or sometimes hardly at all. “You’ll have families where people get cataracts at 60, 70, or 80 years of age, and you’ll also have families where very few people need cataract surgery,” she explained.
Commeting on the reel, Dr Mallaiah said she was not aware of strong evidence linking sunlight exposure directly to cataracts. “I’ve never heard of sunlight causing cataracts,” she remarked.
She then outlined the proven risk factors for early-onset cataracts, stressing that some causes are well established in medical literature. “One of the most important and proven causes is long-term steroid use,” she said. Steroids, whether taken as tablets, applied as eye drops or ointments, or used for chronic medical conditions, are known to trigger early cataract formation.
“Patients with asthma, allergies, autoimmune conditions, or those who have undergone organ transplants are particularly at risk,” she explained.
Dr Mallaiah added that uncontrolled diabetes is another well-established cause of early cataracts. “Uncontrolled diabetes definitely causes early cataracts,” she said. Other proven contributors include eye injuries, trauma, and long-term inflammation inside the eye.
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS.
