Public health
Knowledge about the relationship between smoking and blindness in Canada, the United States, the United Kingdom, and Australia: results from the International Tobacco Control Four-Country Project

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Abstract

Purpose

Smoking is causally associated with certain prevalent visually impairing eye diseases, including age-related macular degeneration and cataract. Studies have found that people are afraid of “going blind” and may be motivated to quit smoking if they know that vision loss is associated with smoking behavior.

Methods

A random-digit dialed telephone survey was used to measure health knowledge of adult smokers in Canada (n = 2,765), the United States (n = 3,178), the United Kingdom (n = 2,767), and Australia (n = 2,623) as part of the International Tobacco Control Four-Country Project.

Results

A low proportion of smokers from Canada (13.0%), the United States (9.5%), and the United Kingdom (9.7%) believed that smoking can cause blindness. In contrast, 47.2% of Australian smokers believed that smoking causes blindness. Australia was the only country during the sampling period to have national awareness campaigns about smoking and its effects on eye health.

Conclusion

These findings point to the need across countries to educate the public on this important consequence of smoking. There is an opportunity for the public health and eye health communities to work to educate the public about the impacts smoking has on eye health to improve quit rates and help discourage people from starting to smoke.

Section snippets

Sample

Eligibility for the ITC-4 Project required participants to (1) live in Canada, the United States, the United Kingdom, or Australia; (2) be 18 years or older; (3) have smoked more than 100 cigarettes in their lives and at least once in the past 30 days; and (4) be willing to complete the ITC-4 phone survey. Between 2004 and 2007, there were 11,333 respondents who were daily smokers (Canada = 2,765; United States = 3,178; United Kingdom = 2,767; Australia = 2,623).

Procedure

The study protocol was reviewed

Results

Table 1 provides sample characteristics by country (n = 11,333) of the unweighted data. The majority of respondents were women (56.2%), at least 25 years old (90.5%), and members of the majority ethnic group for their country (88.9%). Approximately half of the sample (55.2%) was classified as having a lower level of education, and most of the sample (61.1%) was classified as having a medium or high annual income level.

Participants were asked if smoking causes stroke (n = 11,318), impotence in

Discussion

This is the first study to report awareness of “blindness” as a smoking-related condition with nationally representative samples of smokers. Most smokers in this survey were aware of some negative health outcomes from smoking, specifically chronic health issues that can result in death, but relatively few respondents understood that smoking is a risk for non–life-threatening health effects, such as “blindness.” Australians were much more likely to report smoking causes blindness. The most

Conclusion

Smokers recognize that smoking is associated with diseases that cause premature death but are less likely to realize that smoking can cause blindness, a health condition more related to quality of life. These findings suggest that public education campaigns contribute to higher knowledge among smokers about the causal links between smoking and blindness; however, these campaigns may not be enough on their own to raise knowledge in the majority of the public. There is an opportunity for both

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    Disclosure: Research funding is from the National Cancer Institute of the United States R01CA100362 and P50 CA111236 (Roswell Park Transdisciplinary Tobacco Use Research Center), Canadian Institutes of Health Research (57897 and 79551), Robert Wood Johnson Foundation (045734), National Health and Medical Research Council of Australia (265903), Cancer Research UK (C312/A3726), Canadian Tobacco Control Research Initiative (014578), Centre for Behavioural Research and Program Evaluation, National Cancer Institute of Canada/Canadian Cancer Society, and the Ontario Institute of Cancer Research. Additional support is from a Canadian Institutes of Health Research Doctoral Award and the Canadian Institutes of Health Research Strategic Training Program in Tobacco Research.

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