What question did this study set out to answer?

The study aims to evaluate how optometrists in Wales approach discussing smoking status and providing cessation advice.

February 22, 2026Open Access

How Do Optometrists Approach Directed Questioning on Smoking Status in a Centrally Co-Ordinated, Publicly-Funded National Primary Care Eye Health Service?

RJRebecca JohnChristian Medical College, Vellore MGMichael R. GeorgeUniversity Hospital Southampton NHS Foundation Trust GWGwyn Samuel WilliamsSwansea Bay University Health Board

Key Points

The study aims to evaluate how optometrists in Wales approach discussing smoking status and providing cessation advice.
Cross-sectional study using an anonymous online questionnaire.
Assessed smoking-related practices among optometrists in Wales.
Captured demographic data, training history, and barriers to discussing smoking.
96.3% of optometrists routinely assess patients’ smoking status.
Most optometrists feel confident discussing smoking’s health impacts.
Common barriers include time constraints and perceived patient reluctance.
Longer professional tenure correlates with a higher perception of patient reluctance as a barrier.

Abstract

Background: Tobacco use is a leading cause of preventable death worldwide, linked to various health issues, including cancers, cardiovascular diseases, and respiratory illnesses. It also adversely affects ocular health, increasing the risk of conditions like Age-Related Macular Degeneration and cataracts. The socioeconomic burden of smoking in the UK is significant, costing the National Health Service between £ 2.7 and £ 5.2 billion annually. Smoking cessation improves health outcomes and reduces healthcare costs. Optometrists are well positioned to identify smoking behaviours and offer cessation advice, yet evidence on current practice in Wales is limited. Methods: This cross-sectional study used an anonymous online questionnaire to assess smoking-related practice behaviours among optometrists providing National Health Service optometry services in Wales. The survey captured demographic characteristics, training history, current approaches to smoking status identification and cessation advice, confidence levels, and perceived barriers to discussing smoking with patients. Results: A total of 778 optometrists participated, with 96.3% reporting routine assessment of patients’ smoking status. Most respondents felt confident discussing the impact of smoking on health; however, barriers like time constraints and perceived patient reluctance were common. Notably, those with longer professional tenures were more likely to view patient reluctance as a barrier (OR 1.46, 95% CI, 0.026– 0.050, p < 0.001). Conclusion: The findings suggest generally positive engagement with smoking cessation among optometrists in Wales, though barriers to patient engagement persist. While training appears to support more proactive practice, further work is needed to understand how optometric interventions influence smoking cessation outcomes and to explore why some practitioners perceive patients as hesitant to discuss health behaviours. Keywords: smoking, public health, optometry, holistic care, smoking cessation

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