Physician perceptions of e-cigarettes mixed

Chest physicians in the United States are likely to encounter electronic cigarette user in clinical practice, yet there is no consensus regarding how to advise them, results from a survey suggested.

“There is controversy in the community of physicians we surveyed on whether e-cigarettes would be useful for smoking cessation and whether they can reduce harm from tobacco smoking,” lead study author, said in an interview in advance of the annual meeting of American College of Chest Physicians. “Our results suggest that we need more high-quality scientific data regarding potential harms and benefits of e-cigarettes in order to inform both health professionals and the general public.”

A pulmonary and critical care medicine fellow at Yale University, New Heaven, Conn., and his associates e-mailed a brief, online questionnaire to members of the American College of Chest Physicians in an effort to assess practice patterns and perceptions regarding e-cigarette (EC) use tobacco smoking among their patients. As an incentive to participate, respondents were entered into a lottery to win $500. He reported results from 994 members who completed the survey.

Less than half of respondents (44 percent) reported asking patients about EC use either most of the time or always, 88 percent reported that patients had asked their opinion of ECs, and 31 percent reported EC use among at least 10 percent of their patients. More than two-thirds reportedly believing that ECs are harmful (69 percent) and daily EC use is not safe (72 percent).

When asked if ECs promote tobacco cessation respondents were split ( 33 percent agreed or strongly agreed while 32 percent disagreed or strongly disagreed); only 13 percent believed that ECs were at least as effective as Food and Drug Administration – approved treatment to promote smoking cessation, and 11 percent reported that ECs should be used in an initial quit attempt.

It was also reported that 6 percent of respondents thought ECs were more harmful than smoking, 21 percent though switching from daily tobacco smoking to EC use would improve a patient’s health, and 55 percent reported feeling comfortable discussing health effects of ECs with their patients.

“In light of the fact that the long-term health risks of ECs remain unknown, surprised to find that more than half of the survey respondents reported feeling comfortable discussing health effects of ECs. This proportion was higher than expected given the current state of the scientific evidence.”

Acknowledged certain limitations of the survey, including its low response rate, “which limits the degree to which can generalize our findings to account for the perceptions of all chest physicians. Surveyed providers only within CHEST, and opinions and experiences of physicians outside of the organization and in other specialties may vary. And finally, since knowledge regarding e-cigarettes is rapidly evolving, the perceptions and opinions here are likely subject to change over the next few years as more becomes known.”