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A plausible explanation for the association with refractive and accommodation disorders is that this broad outcome may capture changes in visual function related to accommodative dysfunction or ocular surface instability, the authors wrote in their paper

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RELATED: Early adult deaths rising in US: COVID-19, drug overdoses major causes States with the most adult smokers By the numbers: The states with the most smokers are: West Virginia 20.4% Kentucky 17.4% Tennessee 17% Oklahoma 15.8% Louisiana 15.7% States with the least adult smokers By the numbers: The states with the least smokers: Utah 6% Connecticut 8.4% California 8.5% Hawaii 9% Washington 9% Smoking "report card" Dig deeper: The 2025 "State of Tobacco Control" report grades states and the District of Columbia in five areas that have been proven to prevent and reduce tobacco use and save lives, including smoking in the workplace, sale of flavored tobacco, funding for tobacco prevention programs, level of state tobacco taxes and coverage and access to services to quit tobacco

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