General practitioners’ knowledge, attitudes, beliefs and practices surrounding the prescription of e-cigarettes for smoking cessation: a mixed-methods systematic review

Abstract

Background General practitioners (GPs) play an important role in providing patients who smoke with health information, support and treatment to encourage them to quit smoking. Despite conflicting evidence on the effectiveness of electronic cigarettes (e-cigarettes) as a smoking cessation aid, there is growing interest in the role e-cigarettes might play as an alternative to smoking tobacco. This systematic review aims to synthesise evidence from qualitative, quantitative and mixed-methods studies of the knowledge, attitudes, beliefs and social norms of GPs with respect to the use of e-cigarettes as smoking cessation aids. Methods This study adhered to the PRISMA guidelines. Studies from MEDLINE, CINAHL, SCOPUS, PsycINFO, EMBASE and grey literature were searched. Two independent reviewers screened abstracts and full-text articles to identify studies that met the inclusion criteria. A data extraction form was used to extract relevant data from included papers and were quality appraised using the MMAT checklist. A PRISMA flow diagram was used to record the flow of papers and reasons for exclusion. Studies were included if they collected quantitative, qualitative or mixed methods data to determine knowledge, attitudes, beliefs and social norms of GPs for use of e-cigarettes as smoking cessation aids. Results A total of 4056 abstracts were screened and 25 articles were included. Our findings showed that GPs had mixed views on recommending e-cigarettes as a smoking cessation aid. Some GPs were optimistic and had recommended e-cigarettes to their patients. Others were reluctant and disagreed that e-cigarettes are an effective method to quit smoking. Most GPs lacked knowledge and confidence in having discussions with patients around e-cigarette safety and efficacy as smoking cessation alternatives. Conclusion This systematic review shows there are mixed views on e-cigarettes as smoking cessation aids. Clear guidance on the role of e-cigarettes is needed to inform and upskill GPs about e-cigarettes for smoking cessation. PROSPERO registration CRD42021227612.

‘Why do we have to be the gatekeepers?’ Australian general practitioner’s knowledge, attitudes and prescribing intentions on e-cigarettes as a smoking cessation aid

“…Our ndings are consistent with international literature [13,28,29,[31][32][33][34] that more empirical evidence is needed so GP's can provide accurate and effective advice to patients about the use of e-cigarettes as a smoking cessation treatment. A one-page summary or an infographic of the pro's and con's on e-cigarettes or, a quick snapshot of pertinent information that could be handed out to patients for information was desired.…”

“…In a recent systematic review, little was known about GP's preparedness to have discussions with patients about e-cigarettes for smoking cessation and that GP's intentions to prescribe e-cigarettes as smoking cessation treatments were unclear [13].…”

Regulation of endothelial function by cigarette smoke and next-generation tobacco and nicotine products

“…A first-line medical therapy, known to support acute withdrawal, treat cravings as well as to reduce the relapse risk, is a combination of varenicline with different short-acting nicotine patches [ 99 ]. In this context, the concept of using new tobacco products to support smoking cessation is still controversially discussed [ 86 ]. While the prevalence of classical cigarette smoking has been slightly reduced in the last decades, the use of next-generation tobacco products has increased to a similar degree.…”

Smoking Prevalences of All Grades from Oldest Medical School in Turkey and Attitudes of Medical Students as a Potential Role Model

“…for tobacco use or smoking cessation. The perception of alternatives on tobacco products should also be prevented (Selamoglu, Erbas, et al, 2022).…”