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

Abstract

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Family Physicians' Perceptions of Electronic Cigarettes in Tobacco Use Counseling

“…These findings are consistent with concerns echoed by many studies that have shown clinicians misgivings about the effectiveness of the devices. 20,21,26,[31][32][33][34] Interestingly, more than a third of the respondents were unsure about the effectiveness of e-cigarettes, indicating that family physicians are concerned about the uncertainty regarding the efficacy of e-cigarettes as substitutes for cigarette smoking.…”

“…First, the items were created based on the literature on e-cigarettes. 11,20,21,26 The questions generated were reviewed by 2 family physicians and a behavioral scientist, based on their experiences working with tobacco users, to ensure that the questions had face validity. We later sought input from faculty and staff of the KUSM-W DFCM, who ensured that the questions were intuitively understandable.…”

“…16 -19 Conversely, those who oppose the idea of e-cigarettes as smoking cessation aids have argued that little evidence suggests that e-cigarettes are effective nicotine replacement products, 16 -19 and they have proposed that they are just as unhealthy as smoking tobacco cigarettes. 20,21 The opposition has also cited a lack of sufficient evidence supporting the effectiveness of e-cigarettes as smoking cessation products. 22,23 Concern also exists about the potentially deceptive labeling of e-cigarettes.…”

“…Some reports indicate that the nicotine concentration in some e-cigarettes has been found to be significantly different from the content noted on the label. 20 In addition, there are concerns about the potential adverse effects of the flavoring in virtually all e-cigarette products. 24 Inhalation of the derivatives of the flavoring (eg, diacetyl) could, according to Grana and colleagues, 24 cause respiratory diseases such as bronchiolitis obliterans.…”

Vaporised nicotine and tobacco harm reduction for addressing smoking among people living with HIV: A cross-sectional survey of Australian HIV health practitioners’ attitudes

“…Between 48% (Kandra et al, 2014) and 65% (Steinberg et al, 2015) of US physicians report being asked by patients about ecigarettes and such evidence has resulted in guidelines for practitioners responding to such requests (Mendelsohn and Gartner, 2015). Nonetheless, VNPs remain contentious (McNeill, 2016;Meernik and Goldstein, 2016) with opponents highlighting uncertainty around long-term safety, and expressing fear they will renormalise smoking, thus potentially encouraging uptake among young people (Morphett et al, 2016;van der Eijk, 2016).…”