Every time you light a cigarette, you may be doing more harm to your body — and specifically, your eyes — than you think. People who smoke are more likely to develop thyroid eye disease (TED), and if you have TED, your doctor will likely encourage you to quit smoking.

This article will discuss the link between smoking and TED. We’ll explore why smoking negatively affects your TED prognosis and how it makes treatments less effective. We’ll also offer tips on how to quit smoking to keep your eyes healthy. For more information about smoking and TED, talk to your ophthalmologist (eye specialist).

How Are Smoking and TED Connected?

TED is an eye disease that often develops in people living with Graves’ disease, an autoimmune condition that causes the thyroid gland to become overactive. In people with thyroid eye disease, the immune system also affects the tissue in and around the eyes. You may hear doctors call TED by other names, including “Graves’ ophthalmopathy” or “Graves’ orbitopathy.”

Studies show that smoking cigarettes is a major risk factor for developing TED. Smoking can also affect the severity of your symptoms and how well you respond to treatment.

Smoking Increases Your Risk of TED

People who smoke are far more likely to develop TED than people who don’t. The more you smoke, the higher your risk. For example, smoking in general doubles your chances of developing TED. If you smoke and you’ve had radioactive iodine treatment in the past, your risk quadruples, and if you smoke heavily, you are eight times more likely to develop the condition.

Cigarette smoke contains thousands of chemicals that damage your eyes, lungs, and blood vessels. Some of these chemicals prompt your immune system to overstimulate your thyroid.

Researchers have also found that smoking limits how much oxygen reaches the tissues in your body. This is because the chemicals in cigarette smoke constrict your blood vessels. If your eyes can’t get enough oxygen, you may develop inflammation. This inflammation — combined with an autoimmune disease like Graves’ disease — can damage your eyes.

Your TED Symptoms May Be Worse if You Smoke

TED symptoms vary depending on the severity of the condition and can differ from person to person. Those with mild TED usually have dry, gritty eyes that are irritated, red, or watery.

If you still smoke after you develop TED, you may have more serious symptoms. For example, you may develop a condition known as proptosis, which causes your eyes to protrude from your face. Double vision is also common. If left untreated, your condition may progress and eventually lead to vision loss and blindness.

Smoking Makes TED Treatments Less Effective

Controlling inflammation in your eyes is the key to managing TED. Doctors typically prescribe anti-inflammatory medications to help. It’s also important to treat any underlying thyroid disease, like Graves’ disease.

Studies have found that smoking makes TED treatments less effective. For example, one report followed people with TED who were treated with teprotumumab (Tepezza). Some participants smoked, and others didn’t. The study found that those who smoked saw less improvement than those who did not.

If you have TED and Graves’ disease, smoking makes it harder to treat your thyroid condition. Smoking plays a role in inflammation and prevents your thyroid treatments from working properly.

Tips for Quitting Smoking

Quitting smoking can be difficult, especially when you’re hit with strong cravings. We’ve created a list of tips to help you quit for good. Be sure to talk to your doctor about supportive therapies to try as well. You don’t have to go on this journey alone.

Avoid Your Smoking Triggers

Smoking is part of many people’s daily routine. Maybe you smoke a cigarette with your morning coffee or when you’re out with friends. Try to identify parts of your routine or other triggers that prompt you to smoke. Consider switching up your routine with new activities without those associations. It’s also a good idea to have a plan to fight cravings when they inevitably arise.

Talk to Your Doctor About Medications

If you’re having trouble managing intense cravings to smoke, talk to your health care provider. They can prescribe nicotine replacements to help manage your discomfort and improve your chances of quitting. These replacements may include nicotine inhalers or nasal sprays. Many stores also stock nicotine products that don’t require a prescription, like gums, lozenges, and patches.

Other prescription medications like bupropion are approved by the U.S. Food and Drug Administration (FDA) to help people quit smoking. You can take bupropion along with nicotine replacement therapies. Your doctor may recommend prescription medications if you’ve tried other methods but they haven’t worked.

Distract Your Mind and Your Mouth

When intense tobacco cravings hit, try chewing on something instead. Keep a pack of gum or hard candies nearby for when you need a distraction. The Mayo Clinic also recommends snacking on crunchy foods like nuts, seeds, or carrot sticks. Try taking an extra five to 10 minutes to distract yourself and let the craving pass.

Build a New, Healthy Habit

If you still find yourself giving in to your urges, try building a new, healthier habit to replace smoking. Many people find that exercise and meditation help them kick their cravings. Going for a walk or incorporating brief exercise sessions into the middle of your work day — like taking a walk around the block — can do wonders.

Meditation, prayer, yoga, and deep breathing exercises are also great for distracting yourself from cravings. This is especially true if you’re tempted to smoke in stressful situations. Listen to a five-minute breathing or meditation video to ride out the urges. Or start your days by practicing yoga or stretching.

Benefits of Quitting Smoking With TED

Ditching the cigarettes doesn’t just help treat and prevent TED — it also supports your overall health and quality of life. According to the British Thyroid Foundation, your risk of developing TED quickly drops after you quit smoking. Or, if you quit smoking after you’ve already been diagnosed with TED, your treatments are likely to improve as well.

After you quit smoking, you’ll also notice improvements in your overall health. The Centers for Disease Control and Prevention (CDC) notes that smoking cessation:

• Lowers your risk of cancer, lung disease, and cardiovascular disease
• Helps you live a longer, healthier life, potentially by as much as 10 years
• Improves your health, even if you were previously diagnosed with lung or heart disease
• Protects your family, friends, and coworkers from secondhand smoke

Talk With Others Who Understand

On TEDhealthteam, the social network for people living with thyroid eye disease and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with TED.

Did you quit smoking after your thyroid eye disease diagnosis? What tips or words of advice do you have for other members? Share your experience in the comments below, or start a conversation by posting on your Activities page.