Smoking and Your Eyes, Gums and Bones

This page is general information from Health Canada, not medical advice. Changes in vision, bleeding gums or mouth sores that do not heal are reasons to see an eye doctor, dentist or physician.

Does smoking increase the risk of macular degeneration?

Yes. Health Canada’s page says people who smoke are about 2 to 4 times more likely to develop age-related macular degeneration (AMD) than people who have never smoked. It calls AMD the top cause of blindness among adults 55 and older in developed countries and says nearly 200,000 new diagnoses occur in Canada each year. Effective treatment is unavailable in most cases; laser therapy, injected drugs and lifestyle changes may only slow progression.

The mechanism, per the page: harmful chemicals from tobacco smoke enter the bloodstream and reach the retina, where they can cause inflammation and damage. Smoking may also reduce blood flow to other parts of the eye. Twenty years after quitting, the risk is similar to that of someone who never smoked.

What does smoking do to gums and teeth?

Health Canada’s oral disease page puts the risk of gum disease 85% higher in smokers. The effects show up in Canadian adults as complete tooth loss in 7.8% of smokers versus 3.6% of never-smokers, and root decay in 29.5% versus 16.5%. Nicotine reduces the body’s ability to repair damaged gums, and harmful bacteria are more likely to return after gum treatment, so treatment is less likely to succeed.

Gum disease risk drops as early as one year after quitting, and quitting slows progression and improves response to treatment in people who already have it. For someone who quit 13 or more years ago, tooth loss risk matches that of a never-smoker. Stains, skin and appearance are in effects on teeth, skin and appearance.

What about mouth cancer?

Health Canada says smokers have roughly 5 to 10 times the oral cancer risk of people who have never smoked, and that drinking alcohol multiplies the risk. About 40% of new oral cancer cases in 2015 were due to smoking. Risk begins to fall within five years of quitting and, after 20 or more years, is the same as someone who never smoked. Other cancers are in smoking and cancer.

Does smoking affect bones?

We found no Health Canada page devoted to bone health, so there is no official bone-density figure here. Two statements are on the record. The oral disease page calls gum disease a leading cause of tooth loss and bone loss. And the menopause page says smoking brings menopause about one to two years earlier, with early menopause associated with an increased risk of osteoporosis; it gives no numbers for that risk.

For the wider list of effects, see cigarette side effects, and for what changes after the last cigarette, the quitting timeline. Diabetes can also affect the eyes: see smoking and diabetes.