September 14, 2017
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Most family physicians do not recommend e-cigarettes for smoking cessation

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Despite recent support for family physicians to recommend e-cigarettes to patients who are trying to quit smoking, most of them do not, according to findings recently published in the Journal of the American Board of Family Medicine.

“Given the popularity of e-cigarettes among U.S. adults and the large number of smokers who visit a health care professional, there has been support for physicians to recommend e-cigarettes to patients as smoking cessation aids,” Samuel Ofei-Dodoo, PhD, MPA, MA, from the department of family and community medicine at the University of Kansas School of Medicine, and colleagues wrote. “The call for e-cigarettes as smoking cessation aids has been louder since manufacturers, marketers and retailers increasingly advertise these products as such, despite limited reliable data on their effectiveness.”

Researchers utilized a mixed-methods approach to analyze the responses from family physicians who received the 12-item survey. The survey covered topics such as whether or not the physician recommended e-cigarettes for smoking cessation; the relationship between family physicians' career status and their decisions to recommend to patients the use of e-cigarettes for tobacco cessation; and how effective family physicians thought e-cigarettes were as smoking cessation tools.

The number family physicians who responded was 117, for a response rate of 76%.

Ofei-Dodoo and colleagues found that 82% do not recommend e-cigarettes to get a patient to stop smoking. Of the 18% of responding physicians that said they do, it was mainly because e-cigarettes can “serve as a bridge for smokers to quit smoking cigarettes, and e-cigarettes are the lesser of two evils.”

Researchers also wrote that career status was significantly associated with respondents' decision to recommend e-cigarettes.

The proportion of physicians not recommending e-cigarettes was as follows: faculty physicians, 0.89; practicing physicians, 0.8; and resident physicians, 0.95. Of the participants who answered queries regarding the effectiveness of e-cigarettes, 46% believed e-cigarettes were either ineffective or very ineffective, and 43% of those who recommend or have recommended e-cigarettes to patients thought the devices were either ineffective or very ineffective.

“These findings suggest that clinicians (in general) and family physicians (in particular) should recommend against the use of electronic cigarettes. The results are particularly important for primary care physicians, who are the key players in helping the nation to achieve the Healthy People 2020 objectives regarding tobacco use,” Ofei-Dodoo and colleagues wrote.

Family physicians' efforts in helping patients quit smoking should center on the proven best practices, including behavioral support and FDA-approved pharmacotherapy,” they added. “Until more reliable studies are done on the efficacy, quality and safety of e-cigarettes, family physicians should consider recommending only evidence-based smoking cessation products to patients.” – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.