A large-scale study from South Korea is raising new questions about the effects of vaping on eye health.

The research, published in the American Journal of Ophthalmology, suggests that people who switch from cigarettes to electronic vapes may face a higher risk of major eye diseases than those who quit nicotine completely.

Researchers from Korea University College of Medicine analyzed data from 179,273 adults using the Korean National Health Insurance Service.

All participants had smoked traditional cigarettes between 2011 and 2012 and reported quitting by 2018 or 2019.

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To ensure accurate comparisons, the research team matched participants based on age, gender, medical history, overall health conditions, and lifestyle habits. This process resulted in 32,316 matched subjects who were divided into two groups: complete quitters who stopped using all nicotine products, and switchers who turned to smokeless alternatives like vapes.

The participants were monitored for an average of 4.6 years to track the development of serious eye conditions. These included cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy, and vision focus disorders.

During that period, researchers documented 6,328 major eye disease cases. Those who gave up all nicotine use had the lowest rate, with 41.1 cases per 1,000 person-years. Among participants who replaced cigarettes with vapes or other smokeless products, the rate increased to 44 cases per 1,000 person-years.

The findings revealed that switching to smokeless nicotine products was associated with a 7% higher risk of developing significant eye disease compared to quitting nicotine entirely. This pattern remained consistent across different eye conditions measured in the study.

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The results were particularly striking for diabetic retinopathy, where switchers showed a 24% greater risk compared with those who stopped all nicotine. The team also reported a 7% higher likelihood of refractive and accommodation disorders—conditions that affect the eye’s ability to focus.

The research team cautioned that the findings challenge the belief that moving from combustible cigarettes to vape products is harmless to vision. "These findings challenge the assumption that substituting noncombustible nicotine or tobacco products for conventional cigarettes is visually harmless," the authors wrote.

However, the study also noted certain limitations. Because it was based on previously collected insurance data, the analysis cannot definitively prove that vaping directly causes eye damage. Furthermore, the smoking and vaping history relied on self-reported questionnaires, which can be subject to underreporting or memory inaccuracies.

Despite these caveats, the authors concluded that switching to alternative nicotine products may not fully remove the risk of eye disease. They encouraged additional prospective studies to further assess potential links between vaping and ocular health outcomes.

Fox News medical analyst Dr. Marc Siegel also responded to the results, pointing to a broader concern about the addictive nature of vaping and nicotine pouches. Siegel emphasized that these products contain high concentrations of nicotine, raising concerns about their overall effects on the heart and gastrointestinal tract.

He also highlighted the impact of social media in promoting vaping to younger audiences. Siegel expressed worry that marketing aimed at teenagers could normalize nicotine use despite ongoing evidence of potential health effects.

The findings arrive as nationwide smoking rates continue to reach record lows. A report in the New England Journal of Medicine recently found that cigarette smoking among U.S. adults fell to 9.9% in 2024. Yet, health experts warn that the decline in cigarettes has coincided with a rise in vaping, especially among younger generations.

For smokers considering ways to quit, the Korean study underscores the importance of fully stopping nicotine rather than switching to alternative delivery systems. It also reinforces growing efforts in the medical community to better understand the long-term consequences of widespread vaping use.

The researchers concluded that while vaping is commonly perceived as a safer alternative to smoking, it may still come with its own set of health risks—particularly for the eyes.