Abstract Number: Esoc2026ys204 Confidence in Smoking Cessation Therapy After Stroke: A Multi-Centre Questionnaire

Abstract Background and aims Smoking cessation after stroke improves cerebral blood flow within a few months. However, the treatment offered by clinicians varies and may reflect differences in knowledge and confidence rather than patient need. Admission with acute stroke represents a potential “teachable moment”, during which patients may be more receptive to lifestyle change. This study aimed to explore stroke clinicians’ knowledge, confidence, and prescribing practice relating to smoking cessation after stroke. Methods An anonymous questionnaire was distributed to practising stroke clinicians across two centres as part of a quality improvement project. The survey assessed frequency of encountering patients who smoke, routine enquiry about smoking status, confidence in delivering smoking cessation advice, familiarity with very brief advice (VBA), and prescribing practice relating to nicotine replacement therapy (NRT) and varenicline. Results Thirty-two doctors completed the questionnaire, including consultants (38%), junior doctors (25%), and registrars or senior residents (25%). Most respondents encountered patients who smoke frequently, with 68% reporting daily exposure and 60% routinely enquiring about smoking status. Prescribing practice did not reflect this exposure: half reported rarely prescribing nicotine replacement therapy, while only 30% prescribed it once or twice weekly, and 71% had never prescribed varenicline despite its availability on the NHS in England, reflecting inconsistent knowledge of smoking cessation pharmacotherapy and contributing to infrequent use of effective treatments in routine stroke care. Targeted education may improve clinicians’ knowledge and confidence, helping to standardise smoking cessation practice and reduce future vascular risk after stroke. Conflict of interest Nothing to disclose