Primary healthcare provider knowledge, beliefs and clinic-based practices regarding alternative tobacco products and marijuana: a qualitative study

Abstract

Use prevalence of alternative tobacco products and marijuana has increased dramatically. Unfortunately, clinical guidelines have focused on traditional cigarettes with limited attention regarding these emerging public health issues. Thus, it is critical to understand how healthcare professionals view this issue and are responding to it. This qualitative study explored knowledge, beliefs and clinic-based practices regarding traditional and alternative tobacco products (cigar-like products, smokeless tobacco, hookah, e-cigarettes) and marijuana among rural and urban Georgia primary healthcare providers. The sample comprised 20 healthcare providers in primary care settings located in the Atlanta Metropolitan area and rural southern Georgia who participated in semi-structured interviews. Results indicated a lack of knowledge about these products, with some believing that some products were less harmful than traditional cigarettes or that they may be effective in promoting cessation or harm reduction. Few reported explicitly assessing use of these various products in clinic. In addition, healthcare providers reported a need for empirical evidence to inform their clinical practice. Healthcare providers must systematically assess use of the range of tobacco products and marijuana. Evidence-based recommendations or information sources are needed to inform clinical practice and help providers navigate conversations with patients using or inquiring about these products.

Beliefs and practices regarding electronic cigarettes in smoking cessation among healthcare professionals in Slovenia

“…Unfortunately, data do not enable us to find reasons behind this, but maybe the unavailability of clear and enforced workplace guidelines/recommendations on how they should counsel patients regarding ECs could be playing a role. Actually, the vast majority, around 90%, of respondents reports that there are no workplace guidelines/recommendations available or have no knowledge of them being available at their workplace, consistent with some other studies 9,21,25,28 . In our study, respondents from a large minority that reports availability of workplace guidelines/ recommendations are more likely from other provider types (Quitline), other workplaces (Quitline), Health Education Centres/Health Promotion Centres, and those providing smoking cessation support, which could be expected because these are mostly healthcare professionals that receive directions on how to treat ECs at training 'on-the-job', through educational materials and guidelines for their work.…”

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.…”

Overview of Electronic Nicotine Delivery Systems: A Systematic Review

“…323,370,391,440 Most healthcare providers are aware of ENDS. 334,336,377,458 Awareness of ENDS has increased in other countries over time. 326,333,337,356,359,369,374,380,381,396,414,451,452,460,475,483,494 …”

“…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. 335,338,357,400,499 …”