Is Lutein Safe for Smokers? A Review of Clinical Evidence

October 12, 2025 •

3 min read

According to long-term follow-up results from the Age-Related Eye Disease Study 2 (AREDS2), the use of lutein/zeaxanthin supplements was not associated with an increased risk of lung cancer in current or former smokers. This critical finding provides a safe alternative for eye health support, a field where another antioxidant, beta-carotene, was found to pose significant risks for smokers.

Quick Summary

The AREDS2 study concluded that lutein and zeaxanthin supplements are safe for smokers, with no increased risk of lung cancer observed. This finding is in contrast to high-dose beta-carotene supplements.

Key Points

AREDS2 Study Findings: The AREDS2 clinical trial and its 10-year follow-up confirmed that lutein/zeaxanthin supplements do not increase the risk of lung cancer in smokers, unlike high-dose beta-carotene.
Beta-Carotene Risks: High-dose beta-carotene supplements were found to double the risk of lung cancer in current and former smokers, leading to its removal from updated eye vitamin formulas.
Lutein as a Safer Alternative: Following the AREDS2 results, lutein and zeaxanthin became the recommended carotenoids for eye health formulas, particularly for smokers, replacing the risky beta-carotene.
Dietary vs. Supplemental Beta-Carotene: The lung cancer risk is associated with high-dose beta-carotene supplements, not the beta-carotene found in a healthy diet rich in fruits and vegetables.
Quitting is Best: While lutein is safe, the single most important action for a smoker's overall health and vision is to quit smoking, as supplements cannot reverse or prevent all smoking-related damage.
Consult a Doctor: Current and former smokers should always consult a healthcare provider before starting any new supplement, especially for conditions like AMD.

The Critical Distinction Between AREDS and AREDS2

The initial Age-Related Eye Disease Study (AREDS) began in 1992 and showed that a specific combination of high-dose antioxidant vitamins and zinc could slow the progression of age-related macular degeneration (AMD). The original AREDS formula contained beta-carotene. However, other studies like the ATBC and CARET trials revealed a significant risk: high-dose beta-carotene supplements increased lung cancer risk in current and former smokers. This led to the AREDS2 study, which aimed to find a safer alternative to beta-carotene.

Is Lutein Safe for Smokers? The Evidence from AREDS2

The AREDS2 trial evaluated adding lutein and zeaxanthin to the vitamin formula and, in some cases, removed beta-carotene. A 10-year follow-up of AREDS2 participants provided key data on lutein's safety for smokers. Findings indicated no significant increase in lung cancer among participants taking lutein/zeaxanthin, including former smokers. Those receiving beta-carotene, however, had nearly double the lung cancer risk. Lutein and zeaxanthin were found to be effective in slowing late-stage AMD progression, performing as well as or better than the original formula with beta-carotene. Consequently, the AREDS2 formula, replacing beta-carotene with lutein and zeaxanthin, is considered a safe option for individuals with AMD, including smokers.

Lutein and Zeaxanthin: Benefits and Mechanism

Lutein and zeaxanthin are carotenoids concentrated in the macula that act as antioxidants, protecting against oxidative stress from sunlight and blue light. For smokers, who experience increased oxidative stress, antioxidants like lutein may be helpful if they don't introduce additional risks. These carotenoids filter harmful blue light and combat free radicals in the eye.

The Dangers of High-Dose Beta-Carotene for Smokers

The increased risk for smokers is specifically linked to high-dose beta-carotene supplements, not the beta-carotene found in food. Studies showing increased lung cancer risk used doses around 20 mg daily, much higher than typical dietary intake. Beta-carotene from food is considered safe and beneficial. However, high-dose isolated supplements interact differently with cigarette smoke. Smokers should check supplement labels to avoid high levels of beta-carotene.

Comparison of Eye Vitamin Formulas for Smokers


Feature	Lutein/Zeaxanthin (AREDS2 Formula)	Beta-Carotene (Original AREDS Formula)
Associated Lung Cancer Risk for Smokers	No increased risk observed in clinical trials.	Significant increase in lung cancer risk observed.
Effectiveness for AMD	Proven to slow the progression of moderate-to-advanced AMD.	Proven to slow the progression of moderate-to-advanced AMD.
Recommended for Smokers?	Yes, the preferred formula for smokers with AMD.	No, explicitly advised against for smokers and former smokers.
Key Ingredients	Lutein, Zeaxanthin, Vitamins C & E, Zinc, Copper.	Beta-Carotene, Vitamins C & E, Zinc, Copper.

Important Considerations and When to Consult a Doctor

Smokers considering eye supplements should consult a healthcare provider. While lutein is safe, quitting smoking is the most impactful action for overall health and vision. A doctor can advise on appropriate treatment, especially for AMD. A diet rich in carotenoid-rich foods like leafy greens, corn, and eggs is also important and safe for everyone. For more information on the studies, visit the {Link: National Eye Institute website https://www.nei.nih.gov/research/clinical-trials/age-related-eye-disease-studies-aredsareds2/about-areds-and-areds2}.

Conclusion

The AREDS2 study demonstrates that lutein supplementation is safe for current and former smokers. While the AREDS2 formula is recommended for smokers with AMD, quitting smoking is the most crucial step for health.

Frequently Asked Questions

Lutein is structurally different from beta-carotene. The large-scale AREDS2 clinical trial specifically tested and confirmed that lutein does not carry the same lung cancer risk in smokers that high-dose beta-carotene supplements were found to have.

The AREDS2 formula is a revised version of the original eye health supplement that replaces beta-carotene with lutein and zeaxanthin. It is recommended for smokers because it provides the same eye health benefits without the associated risk of increased lung cancer.

No. Quitting smoking is the single most effective way to protect your overall health and vision. While lutein is safe, it cannot negate the wide-ranging damage caused by cigarette smoke.

Yes. Lutein is found naturally in many foods, such as leafy green vegetables (kale, spinach), corn, and eggs. A healthy diet is always recommended, but for those with moderate to advanced AMD, a supplement with the AREDS2 formula may be necessary to achieve therapeutic levels.

High-dose beta-carotene supplements have been shown to increase the risk of lung cancer in smokers and former smokers. A single instance may not cause harm, but long-term use is associated with significant risk, making it crucial to use the correct AREDS2 formula.

No. Smokers should avoid any eye health supplements containing high doses of beta-carotene. It is essential to read the label and ensure the product contains the AREDS2-recommended formula, with lutein/zeaxanthin instead of beta-carotene.

If you are a former smoker and have concerns about previous beta-carotene supplementation, you should speak with your doctor. They can provide guidance based on your personal health history.