Physicians’ Attitudes and Use of E-Cigarettes as Cessation Devices, North Carolina, 2013

Abstract

IntroductionElectronic cigarettes (e-cigarettes) are not currently approved or recommended by the Food and Drug Administration (FDA) or various medical organizations; yet, they appear to play a substantial role in tobacco users’ cessation attempts. This study reports on a physician survey that measured beliefs, attitudes, and behavior related to e-cigarettes and smoking cessation. To our knowledge this is the first study to measure attitudes toward e-cigarettes among physicians treating adult smokers.MethodsUsing a direct marketing company, a random sample of 787 North Carolina physicians were contacted in 2013 through email, with 413 opening the email and 128 responding (response rate = 31%). Physicians’ attitudes towards e-cigarettes were measured through a series of close-ended questions. Recommending e-cigarettes to patients served as the outcome variable for a logistic regression analysis.ResultsTwo thirds (67%) of the surveyed physicians indicated e-cigarettes are a helpful aid for smoking cessation, and 35% recommended them to their patients. Physicians were more likely to recommend e-cigarettes when their patients asked about them or when the physician believed e-cigarettes were safer than smoking standard cigarettes.ConclusionsMany North Carolina physicians are having conversations about e-cigarettes with their patients, and some are recommending them. Future FDA regulation of e-cigarettes may help provide evidence-based guidance to physicians about e-cigarettes and will help ensure that patients receive evidence-based recommendations about the safety and efficacy of e-cigarettes in tobacco cessation.

Family Physicians' Perceptions of Electronic Cigarettes in Tobacco Use Counseling

“…This percentage is smaller than the findings of a study of 128 North Carolina physicians, of whom 35% have recommended electronic cigarettes to their patients who smoke. 35 Interestingly, the small number of family physicians in Kansas who have and do recommend e-cigarettes as cessation aids indicated their awareness of harmful effects associated with the use of any tobacco products, but they believed that e-cigarettes are less harmful. This assertion is consistent with the recommendation by Fiore and colleagues 12 that until more evidenced-based studies are conducted to inform the clinical decisionmaking process, physicians should encourage the use of less harmful products such as e-cigarettes to patients who use combustible tobacco products.…”

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).…”

Should Clinicians Recommend E-cigarettes to Their Patients Who Smoke? No.

“…For clinicians that do recommend ENDS, do they document such in the medical record? Given the rise in medical lawsuits related to ENDS side effects or injuries, 14,15 until such time that medical evidence supports ENDS safety and effectiveness, and robust regulatory frameworks exist, clinicians who recommend ENDS to patients in favor of more effective and safe products 16 may face medico-legal risks.…”