The following review article discusses tobacco's toll on individual and public health, and presents what is currently known about cigarette smoking's risk to ocular health. The article also discusses what eye care professionals – specifically optometrists – can do to help address tobacco use with their patients. Smoking is a leading preventable cause of age-related macular degeneration, and is also causally associated with the development of cataract, thyroid-associated ophthalmopathy, and uveitis. Smoking's causal association with vision loss is now used in some countries' health warning labels that appear on tobacco products and national social marketing materials including the US Centers for Disease Control and Prevention. Despite this uptake in health promotion education, very few eye care professionals regularly engage their patients in discussions about tobacco use. Optometrists can be a helpful addition to a smoking cessation health care network that already involves more than a dozen health care professions including medicine, nursing, pharmacy, dentistry, and dental hygiene. Optometrists can further play an important role in educating younger non-smoking patients about the risk of smoking and vision loss to support tobacco-use prevention. Optometrists report that they feel that addressing tobacco use is "not their job" or argue that this is more appropriately done by a family physician/general practitioner. This review article presents the rationale that all primary care providers have a role and a responsibility to discuss tobacco use with their patients. This review article outlines some techniques and strategies that optometrists can use to begin important discussions with their patients about tobacco use, to both support prevention and cessation efforts to support healthy ocular systems and improve public health. Further strategies that health care practitioners use to either connect patients with cessation services, or strategies that practitioners can deliver are also outlined.
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