The World Health Organization (WHO) has published a new brief about how smokers develop age-related macular degeneration and how people living with them also have the same risk for early vision loss.

In a news release posted on its website Thursday, the WHO highlighted how people living with tobacco users are twice as likely to develop vision problems from second-hand smoke. Meanwhile, smokers stand to develop age-related vision loss up to 5.5 years earlier than non-smokers.

“Smoking increases your risk of developing serious eye conditions and permanent sight loss. Quitting smoking and having regular eye tests can help improve eye health and prevent avoidable sight loss,” the International Agency for the Prevention of Blindness head of knowledge management, Jude Stern, said.

The agency partnered with the WHO in developing the new brief, which also found the increased risk of tobacco users developing cataracts.

According to the full report on tobacco use and vision loss published by WHO earlier this month, around 2.2 billion people worldwide have a vision impairment. Of those, 1 billion have a vision problem that are preventable.

Among the different eye conditions, cataract is considered the leading cause of vision loss in the elderly since it affects 65.2 million people globally. Based on scientific data, tobacco use increases the risk of developing cataracts. However, e-cigarettes were also found to be a risk factor.

The report indicated that e-cigarette flavors could increase the production of free radicals that damage DNA and could lead to the formation of cataracts. E-cigarette use has also been linked to reduced eye blood flow, retinal function alteration, and even eye cancer.

Given the risks, the WHO strongly discouraged the use of tobacco and e-cigarettes to help address vision loss and cataract problems related to the substances.

“WHO urges everyone not to use tobacco and e-cigarettes to protect their overall health, including eye health,” said Vinayak Prasad, the head of the No Tobacco Unit at the WHO.