Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece

Abstract

Introduction. The purpose of this study was to evaluate the knowledge and perceptions of Greek healthcare professionals about nicotine, nicotine replacement therapies and electronic cigarettes. Methods. An online survey was performed, in which physicians and nurses working in private and public healthcare sectors in Athens-Greece were asked to participate through email invitations. A knowledge score was calculated by scoring the correct answers to specific questions with 1 point. Results. A total of 262 healthcare professionals were included to the analysis. Most had daily contact with smokers in their working environment. About half of them considered that nicotine has an extremely or very important contribution to smoking-related disease. More than 30% considered nicotine replacement therapies equally or more addictive than smoking, 76.7% overestimated their smoking cessation efficacy and only 21.0% would recommend them as long-term smoking substitutes. For electronic cigarettes, 45.0% considered them equally or more addictive than smoking and 24.4% equally or more harmful than tobacco cigarettes. Additionally, 35.5% thought they involve combustion while the majority responded that nicotine in electronic cigarettes is synthetically produced. Only 14.5% knew about the pending European regulation, but 33.2% have recommended them to smokers in the past. Still, more than 40% would not recommend electronic cigarettes to smokers unwilling or unable to quit smoking with currently approved medications. Cardiologists and respiratory physicians, who are responsible for smoking cessation therapy in Greece, were even more reluctant to recommend electronic cigarettes to this subpopulation of smokers compared to all other participants. The knowledge score of the whole study sample was 7.7 (SD: 2.4) out of a maximum score of 16. Higher score was associated with specific physician specialties. Conclusions. Greek healthcare professionals appear to overestimate the adverse effects of nicotine, and many would not recommend any nicotine-containing product as a long-term smoking substitute. Additionally, they have poor knowledge about the function and characteristics of electronic cigarettes.

Overview of Electronic Nicotine Delivery Systems: A Systematic Review

“…192–194,214,288,325–327,332,335,336,338,353,354,361,369,372,374,382,384,389,390,446,448,449,453–457,461–464,467,471–474,476,477,484,485,488,490,492,493,495,502,503 In the U.S. and Great Britain, this belief has eroded over time with more individuals mistakenly believing ENDS are as harmful or more harmful that cigarettes. 391,414 Studies suggest that ENDS are also perceived as less addictive than cigarettes, 367,375,403,446 tools that may help users reduce or quit smoking, 320,327,330,338,357,374,448,453,455,458,461,464,467,481,483,485,486,488,493,495,499 less expensive than cigarettes, 335,338,447,455,456,472,499 and more convenient or easier to use than cigarettes.…”

“…Eleven studies described ENDS policies enacted at the local, 775,776 state, 776–780 and country level 781–784 ; others addressed proposed city policies, 785 university policies, 786 public and stakeholder opinion of ENDS policies, 334,340,343,351,354,357,374,392,398,399,443,452,469,484,485,717,787–794 the unmet research needs of state and community tobacco control practitioners regarding ENDS, 795 implementation and enforcement of ENDS policies in hospitals, 796 and policies related to vaping on American transit systems. 797 …”

An appraisal of practice guidelines for smoking cessation in people with severe mental illness

“…proportion recommend e-cigarettes to their patients (Kandra et al, 2014;Moysidou et al, 2016). Research also shows that smokers with mental illness and their carers are interested in using e-cigarettes for smoking cessation and reduction and may approach healthcare providers for information on using e-cigarettes as a smoking cessation method (Meurk et al, 2016b;Sharma et al, 2017).…”

Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness

“…Similarly, despite having concerns about the safety and health effects of e‐cigarettes, one‐third of Greek health practitioners recommended e‐cigarettes to their patients as a quit smoking aid (Moysidou et al . ).…”

“…), limited research has been carried out on practitioners’ and mental health consumers’ views on THR strategies (Harker & Cheeseman ; Moysidou et al . ; Pratt et al . ; Rooke et al .…”