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Optometry schools need to improve training to help people stop smoking

Optometrists remain a neglected healthcare professional group despite being well placed to deliver smoking cessation advice


Academics from City University London have found that the training provided to student optometrists on how to best support smokers to quit is extremely limited in the UK.

The new study, which is published in the journal of Ophthalmic and Physiological Optics, shows that increased curricular coverage of these issues is essential to ensure trainee optometrists are adequately trained and competent in supporting patients to quit smoking. The paper also found that staff need to be trained to improve their own knowledge too.

Smoking remains one of the leading causes of preventable morbidity and mortality. Despite the well-established risks of smoking, approximately 1 in 5 of the current UK population continue to smoke.

Smoking is also risk factor for a number of eye conditions, including age-related macular degeneration (AMD), cataracts and thyroid eye disease. In particular, smoking increases the risk of AMD two-fold and based on the UK population, it has been estimated that approximately 28,000 cases of AMD in older people may be directly attributable to smoking.

Optometrists are well placed to deliver smoking cessation advice to a wide population of otherwise healthy smokers, yet optometrists remain a relatively neglected healthcare professional group in smoking cessation research and policy. This is despite smoking cessation interventions having been shown to be highly cost-effective when delivered by a range of healthcare professionals.

Public awareness of the link between smoking and ocular health is also lacking even though optometrists and other eye care professionals play a critical role in educating the public and encouraging smokers to quit.

To determine the extent of smoking cessation training in UK optometry trainees’ undergraduate and pre-registration training, the City team invited all nine undergraduate optometry schools in the UK to participate in a web-based survey of their curricular coverage and assessment related to smoking cessation, and of perceived barriers to delivering smoking cessation training. A content analysis of the College of Optometrists Scheme for Registration Trainee Handbook 2014 was then conducted to identify competence indicators related to smoking cessation.

The researchers found that trainees are primarily taught about the harmful effects/health consequences of smoking, but no training is provided on how optometrists can actually support their patients to quit. This was evident with the majority of school’s reported dedicating limited hours (0–3) to teaching smoking cessation, and predominantly focused on teaching the harmful effects of smoking (89%). Only one school provides practical skills training for delivering evidence-based smoking cessation interventions, including very brief advice.

The majority of schools (78%) reported that they did not formally examine students on their knowledge or skills for supporting smoking cessation, and rated confidence in their graduates’ abilities to deliver smoking cessation interventions as ‘poor’ (78%). Lack of knowledge amongst staff was identified as the key barrier to teaching about smoking cessation support. The pre-registration competency framework does not include any competence indicators related to providing support for quitting smoking.

Speaking about the study, Dr Fabiana Lorencatto, a Research Fellow in the Health Services Research and Management Division at City University London, said:

“Our study has shown that there is a significant deficit in current curricular coverage regarding smoking cessation at UK optometry schools. Other recent surveys in other countries have found similar findings regarding limited training, particularly in Canada, which indicate this is likely to be a more global issue.

“Optometrists can provide important support in helping patients quit smoking, as the habit is a significant risk factor for a number of debilitating eye conditions such as age-related macular degeneration and thyroid eye disease. As a result, optometry schools across the UK need to improve the training of students – and also staff knowledge – to ensure that the optometrists of tomorrow are best placed to help support people to quit a habit which can badly affect their general health and vision.

”At City University London, we are aiming to readdress the limited education and training in smoking cessation and also aim to disseminated the results of our research to the General Optical Council and professional and representative bodies in the optical sector to develop a more co-ordinated approach to target the problem nationally.”

Lead image: rangizzz /

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