Smoking cessation referrals in optometric practice: A Canadian pilot study

Purpose.: The current pilot study sought to understand optometrists' attitudes toward addressing tobacco use within the scope of their practice, and to identify opportunities within Canada to integrate optometrists as health care partners into the national tobacco cessation network. Methods.: A descriptive qualitative design was used to conduct this pilot study. Five focus groups were conducted with 29 informants, including 11 practicing community optometrists and 18 senior Doctor of Optometry students from the University of Waterloo. Rationales, barriers, and opportunities to practice patterns were identified. Results.: Optometrists and optometry students knew the association of smoking with eye diseases such as age-related macular degeneration and cataract; however, some informants selectively asked patients about smoking behavior based on patient age or visit type. Most informants indicated that they did inform their patients who smoke of their increased risk of developing certain eye diseases; however, very few informants assessed whether their patients wanted to stop smoking and no informants reported that they had ever provided a patient with explicit support for tobacco cessation. This limited role in smoking cessation support for patients due, in part, to insufficient: financial incentives, training and educational tools and materials, knowledge of community resources for cessation treatments, and time during appointments. Several opportunities were identified to better integrate optometry into tobacco control efforts such as optometrists' access to patients, patients' fear of blindness as a tool to motivate behavior changes, and practitioners' openness to change. Conclusions.: Optometrists can be a helpful addition to a smoking cessation healthcare network that already involves more than a dozen health care professions including medicine, nursing, pharmacy, dentistry, and dental hygiene. The findings of this study will be used to develop a national survey of Canadian optometrists' practice patterns regarding tobacco use prevention efforts and cessation supports for their patients.