title: Patient tobacco use in optometric practice: a Canada-wide study.
abstract: OBJECTIVE
  A national census survey of optometrists in Canada measured knowledge of ocular diseases associated with smoking cigarettes and current practice behaviors related to addressing tobacco use with patients, including prevention and cessation. Optometrists were also asked to identify tools to assist addressing tobacco use with patients.
  
  
  METHODS
  An online bilingual (English/French) survey was developed and an e-mail with a link to the survey was sent to all 4528 optometrists registered in Canada. No participation incentives were provided. Frequency data were tabulated for survey items. Logistic regression models were fit to understand respondent characteristics associated with discussing tobacco use prevention and cessation with patients.
  
  
  RESULTS
  The response rate was 19% (850 responses). Almost all respondents (98%) believed that smoking cigarettes was a risk factor for developing age-related macular degeneration; approximately half (55%) assessed the smoking status of patients during their initial visit; 7% reported that they discussed the benefits of tobacco use prevention with patients younger than 19 years; and 33% reported that they always or regularly assess their patients' interest in quitting smoking. Respondents who completed the survey in English were more likely (odds ratio, 2.4; 95% confidence interval, 1.01 to 5.65) to deliver prevention messaging, compared with respondents who completed the survey in French. Male respondents were less likely to assess patients' interest in quitting (odds ratio, 0.7; 95% confidence interval, 0.50 to 0.97) than female respondents. Most respondents (90%) were interested in a continuing education program about the impact of smoking on vision and eye health as well as strategies for discussing tobacco cessation and prevention.
  
  
  CONCLUSIONS
  Optometrists are aware of the impact of smoking on ocular health; however, most respondents do not systematically engage in tobacco use prevention and cessation practices. Providing optometrists with tools, including continuing education, may help support patient conversations about the risks of tobacco use and improve public health.
authors.affiliation: *PhD †OD, PhD ‡MPH §OD, MSc ∥RN, PhD Johns Hopkins Bloomberg School of Public Health, Institute for Global Tobacco Control, Department of Health, Behavior, and Society, Baltimore, Maryland (RDK); Propel Centre for Population Health Impact (RDK, OD), University of Waterloo Schools of Optometry and Vision Science (MMS) and Public Health and Health Systems (DH), Department of Psychology (GTF), Department of Statistics and Actuarial Science (MET), University of Waterloo, Waterloo, Ontario, Canada; École d'optométrie, Université de Montréal, Montréal, Quebec, Canada (JB); School of Public Health and Health Systems, Waterloo, Ontario, Canada (DH); Ontario Institute for Cancer Research, Toronto, Ontario, Canada (GTF); and Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada (ASHS).
authors.forename: Ryan David
authors.initials: RD
authors.lastname: Kennedy
authors.forename: Marlee M
authors.initials: MM
authors.lastname: Spafford
authors.forename: Ornell
authors.initials: O
authors.lastname: Douglas
authors.forename: Julie
authors.initials: J
authors.lastname: Brûlé
authors.forename: David
authors.initials: D
authors.lastname: Hammond
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Fong
authors.forename: Mary E
authors.initials: ME
authors.lastname: Thompson
authors.forename: Annette S H
authors.initials: AS
authors.lastname: Schultz
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada / Q000453:epidemiology; D005128:Eye Diseases / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008268:Macular Degeneration / Q000517:prevention & control; D008297:Male; D009907:Optometry / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D011364:Professional Practice / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D011634:Public Health; D012307:Risk Factors; D011795:Surveys and Questionnaires; D020340:Tobacco Use Cessation / Q000379:methods; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control