Family Physicians' Perceptions of Electronic Cigarettes in Tobacco Use Counseling

Abstract

Background: Recent support has been shown for physicians to recommend e-cigarettes to patients who are trying to quit smoking. Supporters of this recommendation argue that e-cigarettes are not combustible products and are less harmful and more effective cessation products than regular cigarettes, with less inherent risk. Those who oppose this idea argue that little reliable evidence suggests that e-cigarettes are better cigarette cessation devices than currently available nicotine replacement therapies, and that they pose as much risk as cigarettes. This study was conducted to explore family physicians' perceptions of recommending e-cigarettes as smoking cessation aids to patients who smoke cigarettes.Methods: The study used a mixed-methods approach whereby a 12-item survey was sent to 154 family physicians throughout the state of Kansas. Data were collected from 117, a 76% response rate. A multidisciplinary team used an immersion-crystallization approach to analyze the content of respondents' qualitative data; contingency table analysis was used to evaluate the quantitative data.Results: The results showed that family physicians have negative perceptions of e-cigarettes and do not recommend them for smoking cessation. Family physicians are concerned about the effectiveness of e-cigarettes and the uncertainty regarding safety.Conclusions: The results suggest that most family physicians do not recommend e-cigarettes for smoking cessation, citing lack of evidence on effectiveness and uncertainty regarding short-and longterm safety. (J Am Board Fam Med 2017;30:448 -459.)

Discussions between health professionals and smokers about nicotine vaping products: results from the 2016 ITC Four Country Smoking and Vaping Survey

“…Our findings also showed that just over half of the reported discussions about NVPs were initiated by the smokers themselves, and not by the HP, which may indicate that HPs do not feel entirely comfortable or confident bringing up the topic. This has also been found in other studies, where reasons for not advising about NVPs have included the HP's perceived uncertainty about the safety and efficacy of NVPs , negative beliefs , lack of knowledge , and lack of confidence in their own capacity to counsel smokers about NVPs . These cited studies, however, have mainly been conducted in the United States using convenience samples, with limited data on common practices in other countries.…”

“…The majority of research on HP–smoker discussions about NVPs comes from cross‐sectional and qualitative surveys of physicians. These studies have indicated that dialogues about NVPs have become increasingly frequent in clinical settings , are generally initiated by the patient , and typically do not end in a recommendation to use NVPs, apparently because most providers remain neutral or advise against use . To the best of our knowledge, only two studies have examined patient–physician NVP discussions from the patient's perspective .…”

Prevalence and Etiology of Burnout in a Community-Based Graduate Medical Education System: A Mixed-Methods Study

“…Standard descriptive statistics, Fisher exact test, and Kruskal-Wallis test were used to analyze the quantitative data. The study team analyzed the content of the openended responses (qualitative data) individually and in two team meetings using an immersion-crystallization approach [20][21][22] -a dual process involving detailed review of textual data and momentarily suspending the immersion process to reflect on emerging findings until consistent themes are identified. 20,21…”

Evolución del consumo de alcohol y tabaco en jóvenes en España, posterior a la ley 42/2010 frente al tabaquismo: 2011-2014.

“…Estos datos del presente estudio se pueden deber al auge del uso de cigarrillos electrónicos, como puede verse en varios estudios en universitarios (Copeland, Peltier y Waldo, 2017;Rakotozandry et al, 2016) y jóvenes en general (Carroll y Wu, 2014;Peiper et al, 2016) donde afirman que ha aumentado el uso de este dispositivo en jóvenes y abalan el uso del cigarrillo electrónico como medida para dejar de fumar tabaco, sobretodo en jóvenes. En contraposición, otras investigaciones (Brose, Hitchman, Brown, West y McNeill, 2015;Córdoba, 2014;Ofei-Dodoo, Kellerman, Nilsen, Nutting y Lewis, 2017;Shi et al, 2016;Sutfin, McCoy, Morrell, Hoeppner y Wolfson, 2013) no consideran el uso de cigarrillos electrónicos como medida para dejar de fumar, pero sí para reducir el consumo.…”