Association between alcohol and tobacco use and primary open-angle glaucoma: the Eyes of Africa study.

Authors

Oluwatobi J Hussain, Olusola Olawoye, Kelsey V Stuart, Tarela Sarimiye, Chimdi Chuka-Okosa, Ugbede Idakwo, Naa Naamuah Tagoe, Kwesi Nyan Amissah-Arthur, Kuburat O Adenrele, Nkiru Kizor-Akaraiwe, Chinedu Anthony Okeke, Akinyemi O Adedeji, Bola Adekoya, Aderonke Baiyeroju, Onoja M Akpa, Oluwole Majekodunmi, Nkechi Uche, Bernice Adegbehingbe, Adeola Onakoya, Oyetunde E Oyedepo, Chimdia Ogbonnaya, Bolajoko Abidemi Adewara, Joseph Matiya Msosavict, Akosua Badu Mensa-Bonsu, Kwaku Oppong Kwarteng, Yakubu Seidu Adam, Kwame Okyere Osei, Edem Lodoh, Benjamin Abaidoo, Raymond Toseafa, Suhanyah Okeke, Obinna Shiweobi, Steve Adebusoye, Kayode Fowobaje, Benedict Gboyega Ajayi, Adeyinka Falusi, Oluwafumbi Adeboye, Promise Okoroafor, Ifeyinwa Obianwu, Caroline Adeoti, Adedapo Adejuwon, Nathan Congdon, Anthony P Khawaja, Michael A Hauser, Tony Realini, Adeyinka Ashaye

Published in

Eye and vision (London, England). Volume 13. Issue 1. Oct 10, 2026. Epub Oct 10, 2026.

Abstract

Primary open-angle glaucoma (POAG) is the most prevalent glaucoma subtype globally and has disproportionately high rates in Africa. While smoking and alcohol consumption are established risk factors for several ocular conditions, their associations with POAG remain unclear. This study examined substance use patterns among individuals with and without POAG in sub-Saharan Africa.
This cross-sectional study included 9,418 participants aged ≥ 40 years (5,189 POAG cases and 4,229 controls) from the Eyes of Africa: Genetics of Blindness study conducted across Nigeria, Ghana, and Malawi between 2017 and 2023. Comprehensive ocular examinations were performed, and POAG was diagnosed according to the International Society of Geographical and Epidemiologic Ophthalmology criteria. Sociodemographic data and detailed information on the use of substances including alcohol, tobacco, pharmaceutical substances, and illicit drugs, were collected through structured interviews. Chi-squared tests were used to examine the associations between variables, and multivariable logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for substance use and POAG status.
Alcohol consumption and tobacco smoking were strongly and independently associated with POAG (P < 0.001). Former (OR = 1.49; 95% CI: 1.33-1.66; P < 0.001) and current drinkers (OR = 1.15; 95% CI: 1.00-1.31; P = 0.04) had higher odds than never-drinkers. Lifetime heavy episodic drinking (> 2 drinks per occasion) was associated with 40% higher odds of POAG (95% CI: 1.20-1.65; P < 0.001) than having ≤ 2 drinks. Tobacco use was also independently associated with POAG among both former (OR = 1.38; 95% CI: 1.13-1.68; P = 0.002) and current smokers (OR = 1.46; 95% CI: 1.12-1.91; P = 0.005). In addition, older age, male sex, higher educational level, and unemployment (all P < 0.001) were independently associated with POAG.
Cigarette smoking and alcohol use are significantly associated with increased risk of POAG in this African population, representing potentially modifiable risk factors. Confirmatory longitudinal studies are needed to establish causality. If validated, public health strategies for POAG prevention in Africa should incorporate substance use reduction as a key component of primary prevention.

PMID:
42855702
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

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