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Optometrists well suited to play a role in smoking cessation
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One need look no further than the presidential primaries to see how prevalent controversy is in today’s society. As candidates campaign from state to state, each and every issue evokes a differing opinion and, hence, controversy.
Of course, as health care providers, we deal with our share of controversy as well. We sift through controversies regarding disease diagnosis and treatment, public health policies and how care is delivered (and paid for) every day. It is for precisely this reason we welcome certainty.
While some certainties – such as prescribing minus lenses for myopia – are understood and agreed upon by doctors and patients alike, not all are so clear. Smoking is one such example. We are well aware of the visual detriments of smoking, but sadly the same cannot be said of our patients.
Tobacco-related deaths
In its Global Tobacco Epidemic 2008 report (February 2008) the World Health Organization reminds us of the stark realities of tobacco use and its negative impact on mankind. It is estimated that tobacco use accounted for more than 100 million deaths in the 20th century and currently kills an additional 5.4 million people worldwide annually. If unchecked, this number will reach 8 million per year by 2030 and ultimately account for 1 billion deaths over the next century.
The WHO also points outs that tobacco use is a risk factor in six of the eight leading causes of death worldwide, including: ischemic heart disease, cardiovascular disease, chronic obstructive pulmonary disease and lung/respiratory tract cancers. Simply put, tobacco will play a role in the death of almost 50% of those who use it.
Recognizing the widespread nature of this tobacco epidemic – and its presence in both developed and emerging nations – the WHO has implemented a program called MPOWER. The pneumonic underscores an ambitious initiative: Monitor tobacco use and prevention programs, Protect the public from tobacco exposure, Offer people ways to quit, Warn the public regarding tobacco dangers, Enforce bans on tobacco advertising and promotion and Raise taxes on tobacco products.
While the WHO’s MPOWER program is earmarked for governing bodies, it does send a clear message to all health care providers – play an active role in tobacco use prevention and cessation.
As primary care optometrists, we are perfectly well suited to play such an active role. We understand that smoking is a well documented risk factor in the progression of certain cataracts, age related macular degeneration, anterior ischemic optic neuropathy, thyroid eye disease and diabetic retinopathy and may play a role in glaucoma and ocular surface disease as well. Unfortunately, all too often we mistakenly assume our patients understand the ocular risks of smoking as well.
Patient education needed
This is simply not the case, with studies confirming that only 15% to 30% of all people are even aware smoking is potentially harmful to their eyes. It is for this reason our patient education efforts are so important.
These efforts should go well beyond education and include an active role in initiating a smoking cessation program. We must be sure patients understand their smoking cessation options, communicate with their primary care physician and provide supportive follow-up.
In short, a few moments spent warning of the ocular risks of smoking and offering ways to quit can go a long way in preventing blindness, if not saving a life. No controversy here.