Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

Geletko, Karen W.; Myers, Karen; Brownstein, Naomi C.; Jameson, Breanna; López, Daniel; Sharpe, Alaine; Bellamy, Gail

doi:10.1177/2333392816678493

Cited by 12 publications

(27 citation statements)

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“…After removal of duplicates and publications that did not meet the inclusion criteria, 45 articles were included (see Figure 1), consisting of 32 quantitative cross-sectional studies [17][18][19][20] , twelve qualitative studies [61][62][63][64][65][66][67][68][69][70][71][72] and one mixed methods study 73 . The studies were conducted between 2013 and 2018 and most were from the United States 17,19,20,33,35,39,40,42,48,[50][51][52][53][54]60,[62][63][64][66][67][68]70,73 or the UK 37,38,43,44,55,57,58,61,…”

Section: Resultsmentioning

confidence: 99%

“…Some studies directly measured relative harm of ENDS by asking "In patients who smoke, ENDS are safer than conventional cigarettes", with answers possible from "Strongly disagree" to "Strongly agree" 19,38,49,50,59 . Others stated "ENDS are a safe alternative to conventional cigarettes" with a "Yes/No" option 39,48 .…”

Section: Synthesis Of Quantitative Findingsmentioning

confidence: 99%

“…About 5% of pediatricians and family medicine physicians in the US 20 and 71% of quitline counselors in the U.S. and Canada 46 believed that second-hand aerosol might be harmful. Across studies, the majority of HCPs believed that nicotine containing ENDS are addictive 39,41,46,47 and have the potential to be a "gateway" to smoking among youth 20,42,49,50,55 .…”

Section: Beliefs Of Hcps Toward Perceived Risk Of Endsmentioning

confidence: 99%

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Beliefs and Self-reported Practices of Health Care Professionals Regarding Electronic Nicotine Delivery Systems: A Mixed-Methods Systematic Review and Synthesis

Erku

Gartner

Morphett

et al. 2019

Nicotine &Amp; Tobacco Research

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Aims This review explores the (1) beliefs and attitudes of health care professionals (HCPs) toward electronic nicotine delivery systems (ENDS) including use as a smoking cessation aid and/or harm reduction, safety and regulation, and (2) the extent and content of patient–HCP communication about ENDS. Methods PubMed, Embase, CINAHL, and PsycINFO were searched to identify articles published since 2003. The Mixed Methods Appraisal Tool and Strengthening the Reporting of Observational Studies in Epidemiology checklists were used to assess the quality of studies. Thematic synthesis was used to analyze qualitative data. Results A total of 45 articles (32 quantitative, 12 qualitative, and 1 mixed) were included. There was wide variation regarding beliefs about the efficacy of ENDS as a cessation aid. Although the majority of HCPs believes that ENDS are safer than combustible cigarettes, they also have concern about the short and long-term safety of ENDS, uptake by adolescents, and the potential for ENDS to act as a “gateway” to smoking cigarettes. Beliefs about ENDS are influenced by media stories and experiences provided by patients. Although most HCPs do not proactively recommend ENDS, they are more likely to support ENDS use among patients with smoking related comorbidities, heavy smokers with previous unsuccessful quit attempts, or patients who express interest in trying them. Conclusions Overall, HCPs hold diverse views about the efficacy of ENDS and expressed wariness over their potential health effects. HCP endorsement of ENDS use seems to depend largely on patient health status, the presence of other competing risk factors and patient preferences. Implication Although evidence on safety and efficacy of ENDS is emerging, HCPs should be honest with their clients, stating that the long-term safety is not yet established but what is known is that they appear to be a lower risk alternative to cigarettes. Our review highlights a need for further training and support for HCPs regarding ENDS use, which would enable them to guide their clients in making evidence-based decisions.

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Section: Resultsmentioning

confidence: 99%

Section: Synthesis Of Quantitative Findingsmentioning

confidence: 99%

Section: Beliefs Of Hcps Toward Perceived Risk Of Endsmentioning

confidence: 99%

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Beliefs and Self-reported Practices of Health Care Professionals Regarding Electronic Nicotine Delivery Systems: A Mixed-Methods Systematic Review and Synthesis

Erku

Gartner

Morphett

et al. 2019

Nicotine &Amp; Tobacco Research

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“…A self-administered questionnaire was adapted from previous relevant literature. [21][22][23] The questionnaire was in English then translated into Arabic language and backtranslated into English for validation. A pilot test included 25 subjects (10 of health care provider and 15 of general populations) to test accuracy and the language of the questionnaire.…”

Section: Study Toolmentioning

confidence: 99%

<p>A survey exploring knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt</p>

Dwedar

Ruby

Mostafa

2019

COPD

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Background: Electronic cigarettes are increasing in popularity, and they are easily accessible in a variety of locations. Despite increasing its popularity, little is known about its overall health effects. Physicians have rated the most trustful source of information about it and play also a role in disseminating information about it. Thus, this study identified the difference in knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt. Methods: A cross-sectional study using the self-administered questionnaire in the Arabic language was conducted between December 2018 and March 2019 in the Chest Department in Ain Shams University Hospital in Egypt. Study population (n=610) was divided into health care providers (n=260) and general population (n=350). Result: A total of 593 respondents participated in this study and returned filled questionnaire with total response rate=97.2%, only 8.8% of all participates were smokers, none of the study population reported using electronic cigarettes, despite that, 79.3% of the participants have heard of electronic cigarettes, media advertisements were the main source of getting to know it and there was a statistically significant difference between both groups regarding most beliefs and attitudes toward electronic cigarettes. Conclusion: There was high awareness about electronic cigarettes in Egypt and more negative attitude about it among health care providers than the general population, but still educational programs and guidelines for health care providers are needed to raise more the awareness which will aid in counseling general population appropriately.

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“…[20][21][22] Additionally, the few physician studies in the US regarding e-cigarette communications suggest that while physicians were unlikely to recommend e-cigarettes for smoking cessation, 15,23 they are open to recommending e-cigarettes in the future if data becomes available suggesting effectiveness. 24 Although some early data exist regarding e-cigarette physicianpatient communications in the US, with one exception 14 the US studies were limited to local convenience samples [25][26][27] and/or single specialties. [28][29][30] Furthermore, these products, the scientific evidence base, and the policy environment surrounding e-cigarettes are evolving.…”

Section: Introductionmentioning

confidence: 99%

Electronic cigarette communications between patients and physicians in the United States

Delnevo

Jeong

Teotia

et al. 2021

Preprint

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ImportancePhysicians play a primary role in smoking cessation, and their communication regarding e-cigarettes needs to be understood.ObjectiveTo examine physician-patient communication regarding e-cigarettes.DesignA national, repeated cross-sectional survey in 2018 and 2019 was conducted.SettingParticipants were invited by mail; surveys were completed online.ParticipantsResponse rates were 51.8% (2018) and 59.1% (2019), resulting in 2,058 board-certified physicians from family medicine, internal medicine, obstetrics/gynecology, cardiology, pulmonary/critical care, and hematology/oncology.ExposuresPhysician demographics, tobacco use, medical specialty, and harm-reduction beliefs (i.e., not all tobacco products equally harmful); two hypothetical clinical scenarios.Main outcomes and measuresPhysicians’ self-reported e-cigarette communication behaviors (being asked about e-cigarettes by patients and recommending e-cigarettes to patients), and hypothetical e-cigarette communication in two clinical scenarios.ResultsAmong 2,058 physicians, the mean age was 51.6 years and 41.5% were female. Over 60% of physicians believed all tobacco products are equally harmful. Overall, 69.8% of physicians reported ever being asked about e-cigarettes by their patients (35.9% in the past 30 days), while 21.7% reported ever recommending e-cigarettes to a patient (9.8% in the past 30 days). Pulmonologists (adjusted odds ratio [AOR], 2.14, 95% CI, 1.10-4.16) and cardiologists (AOR, 2.04; 95% CI, 1.03-4.05), as well as physicians who implemented the US Public Health Service Clinical Practice Guidelines (AOR, 1.77; 95% CI, 1.12-2.80) had greater odds of recommending e-cigarettes to patients. Physicians who endorsed a harm-reduction perspective (AOR, 3.04, 95% CI, 2.15-4.31) and had ever smoked cigarettes (AOR, 1.98; 95% CI, 1.27-3.08) were significantly more likely to recommend e-cigarettes. Being asked about e-cigarettes by patients was a strong predictor of physicians’ recommending (AOR,16.6; 95% CI, 10.3-26.7). In clinical scenarios, physicians were overall more likely to recommend e-cigarettes for cessation to an older, heavy smoker with multiple unsuccessful quit attempts than a younger, light smoker with no prior cessation treatments (49.3% vs. 15.2%, p<.001).Conclusions and relevanceFindings suggest physicians may recommend e-cigarettes for cessation under certain circumstances. Given the role of e-cigarettes in FDA’s comprehensive nicotine policy, there is need for continued physician education regarding e-cigarette efficacy, particularly correcting misperceptions regarding harm reduction.Key PointsQuestionHow do physicians communicate with their patients about e-cigarettes?FindingsIn this repeated cross-sectional survey of 2,058 respondents, physicians who were asked about e-cigarettes by their patients, endorsed a harm-reduction perspective, or had ever smoked were significantly more likely to recommend e-cigarettes to patients. Clinical scenarios showed physicians were significantly more likely to recommend e-cigarettes for an older, heavy smoker with prior unsuccessful quit attempts, and use of FDA-approved pharmacotherapy for a younger, light smoker with no prior cessation treatments.MeaningPhysicians may recommend e-cigarettes for cessation under certain circumstances, warranting continued physician education regarding e-cigarette efficacy.

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Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

Cited by 12 publications

References 32 publications

Beliefs and Self-reported Practices of Health Care Professionals Regarding Electronic Nicotine Delivery Systems: A Mixed-Methods Systematic Review and Synthesis

Beliefs and Self-reported Practices of Health Care Professionals Regarding Electronic Nicotine Delivery Systems: A Mixed-Methods Systematic Review and Synthesis

<p>A survey exploring knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt</p>

Electronic cigarette communications between patients and physicians in the United States

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