Seeing new opportunities to help smokers quit: A UK national survey of optometrist delivered smoking cessation behavioural support interventions.

Background: Smoking is a risk factor for various eye conditions. Brief smoking cessation interventions have demonstrated effectiveness when delivered by a range of healthcare professionals. Optometrists are well-placed in the community to advise otherwise healthy smokers to quit, yet remain relatively neglected in smoking cessation research and policy. In a national survey, this study investigated self-reported practices of UK optometrists for delivering brief tobacco smoking cessation interventions to patients.

Methods: A randomly selected sample of 1,200 optometrists out of the 9000 optometrists registered on the UK College of Optometrists database were invited to complete a 40-item, web-based survey assessing: training related to smoking cessation; current practice [i.e. the proportion of patients to which components of very brief advice (Ask, Advise, Assist) and other evidence-based smoking cessation behaviour change techniques were delivered]; and barriers/enablers to intervention delivery.

Results: In total, 408 (34%) responses were received. Most (83%) optometrists received no training in practical skills for delivering smoking cessation support. A third (34%) routinely assessed smoking status. Fewer self-reported advising smokers to quit (22%), offering assistance (via referral to dedicated services) (3%), or advice on smoking cessation medications (2%). Perceived barriers included insufficient knowledge/training (81%) and time (65%). Optometrists were more likely to assess and advise on smoking cessation if they practised in Scotland (χ²(2)=32.95,  p<0.001), an independent optometry practice (χ²(1)=4.27,  p=0.39), or had received smoking cessation training χ²(1)=13.1,  p<0.001).

Conclusions: Substantial gaps exist in UK optometrists' current smoking cessation training and practice. Evidence-based training resources are needed to support the implementation of smoking cessation interventions into routine optometry practice.

Implications: Optometrists are well placed in the community to delivery brief advice interventions to a large population of smokers. This survey provides a comprehensive description of current UK optometry practice related to the provision of evidence-based brief tobacco smoking cessation interventions to patients. Although optometrists perceive advising on smoking cessation as part of their role, numerous substantial gaps in current practice and training remain which need to be addressed through targeted interventions to increase implementation.