E-cigarettes and the clinical encounter: Physician perspectives on e-cigarette safety, effectiveness, and patient educational needs

J Eval Clin Pract. 2019 Oct;25(5):761-768. doi: 10.1111/jep.13111. Epub 2019 Feb 19.


Rationale, aims, and objectives: There is limited research on how health care providers approach the topic of e-cigarettes in clinical encounters, especially in conjunction with other best-practice recommendations for smoking cessation. This qualitative study explored physician perceptions and recommendations involving e-cigarettes in the context of smoking cessation counselling, including their opinions about the implementation and content of patient educational materials that focus on e-cigarettes.

Methods: Semistructured interviews were conducted with 15 physicians from family medicine, internal medicine, and obstetrics/gynaecology (OB/GYN).

Results: Physicians did not routinely assess e-cigarette use among patients and reported that discussions were often initiated by patients. Only a minority of participants discussed e-cigarettes in conjunction with other best-practice recommendations for smoking cessation. Most others were more ambivalent about e-cigarette safety and effectiveness for cessation and did not address the topic, unless patients were already using e-cigarettes. Almost all, however, agreed that more research on e-cigarettes was needed. Physicians expressed an interest in having enhanced discussions about e-cigarettes with their patients and in using patient educational materials to accomplish this. Physicians recommended that these materials not actively promote e-cigarettes and be tailored to patients based on their demographics and motivation to quit.

Conclusions: Physicians were open to improving their smoking cessation counselling and to integrating new patient educational materials that addressed e-cigarettes. Patient educational materials that provide tailored information about e-cigarettes could potentially be used initiate e-cigarette discussions and inform smokers about what is known vs unknown about e-cigarettes.

Keywords: patient-centred care; public health.

MeSH terms

  • Attitude of Health Personnel*
  • Counseling / methods
  • Humans
  • Patient Education as Topic / methods
  • Patient-Centered Care / methods*
  • Physicians* / psychology
  • Physicians* / statistics & numerical data
  • Public Health
  • Qualitative Research
  • Smoking / therapy
  • Smoking Cessation* / methods
  • Smoking Cessation* / psychology
  • Smoking Prevention / methods*
  • Vaping / psychology*