Healthcare providers' beliefs and attitudes about electronic cigarettes and preventive counseling for adolescent patients

J Adolesc Health. 2014 Jun;54(6):678-83. doi: 10.1016/j.jadohealth.2013.10.001. Epub 2013 Dec 9.


Purpose: Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems that may serve as a "gateway" to tobacco use by adolescents. Use of e-cigarettes by U.S. adolescents rose from 3% in 2011 to 7% in 2012. We sought to describe healthcare providers' awareness of e-cigarettes and to assess their comfort with and attitudes toward discussing e-cigarettes with adolescent patients and their parents.

Methods: A statewide sample (n = 561) of Minnesota healthcare providers (46% family medicine physicians, 20% pediatricians, and 34% nurse practitioners) who treat adolescents completed an online survey in April 2013.

Results: Nearly all providers (92%) were aware of e-cigarettes, and 11% reported having treated an adolescent patient who had used them. The most frequently cited sources of information about e-cigarettes were patients, news stories, and advertisements, rather than professional sources. Providers expressed considerable concern that e-cigarettes could be a gateway to tobacco use but had moderately low levels of knowledge about and comfort discussing e-cigarettes with adolescent patients and their parents. Compared with pediatricians and nurse practitioners, family medicine physicians reported knowing more about e-cigarettes and being more comfortable discussing them with patients (both p < .05). Nearly all respondents (92%) wanted to learn more about e-cigarettes.

Conclusions: Healthcare providers who treat adolescents may need to incorporate screening and counseling about e-cigarettes into routine preventive services, particularly if the prevalence of use continues to increase in this population. Education about e-cigarettes could help providers deliver comprehensive preventive services to adolescents at risk of tobacco use.

Keywords: Adolescent health; Electronic cigarette; Electronic nicotine delivery system; Medical education; Nicotine; Smoking.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Analysis of Variance
  • Attitude of Health Personnel*
  • Child
  • Counseling / methods*
  • Counseling / statistics & numerical data
  • Electronic Nicotine Delivery Systems / psychology*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Personnel / psychology*
  • Humans
  • Male
  • Minnesota
  • Tobacco Use / prevention & control*
  • Tobacco Use / psychology