Beliefs, Attitudes, and Confidence to Deliver Electronic Cigarette Counseling among 1023 Chinese Physicians in 2018

Int J Environ Res Public Health. 2019 Aug 30;16(17):3175. doi: 10.3390/ijerph16173175.


Background: The use of electronic cigarettes (e-cigarettes) is gaining popularity, so it is important to evaluate physicians' understanding of e-cigarettes. This study assessed the beliefs, attitudes, and confidence in e-cigarette counseling among Chinese physicians and explored the factors related to asking patients about e-cigarette use. Methods: Physicians from across China were invited to participate in a questionnaire survey using the platform provided by DXY ( in 2018. In total, 1023 physicians completed the online survey. Descriptive analyses were used to characterize the participants, and multivariate logistic regression analyses were applied to identify predictors of physicians' asking about patients' e-cigarette use. Results: Only 46.3% of respondents agreed that e-cigarettes had adverse health effects, and 66.8% indicated that e-cigarettes can be regarded as a type of smoking cessation treatment. We found that 61.3% thought it was important to discuss e-cigarettes with patients, and 71.7% reported feeling confident about their ability in counseling about e-cigarettes. Respondents who had used e-cigarettes (OR = 2.05; 95% CI: 1.16-2.63), had received training about e-cigarettes (OR = 3.13; 95% CI: 2.17-4.52), or were confident about their ability to answer patients' question about e-cigarettes (OR = 2.45; 95% CI: 1.65-3.65) were more likely to ask patients about e-cigarette use. Physicians who showed a supportive attitude toward using e-cigarettes to quit smoking (OR = 0.79; 95% CI: 0.63-0.99) were less likely to ask about patients' e-cigarettes use frequently. Conclusions: Chinese physicians appeared to ignore the adverse health effects of e-cigarettes, and considered e-cigarettes as a smoking cessation treatment. Comprehensive training and regulations are needed to help physicians incorporate the screening of e-cigarette use into routine practice and provide patients truthful information as new data emerge.

Keywords: attitude; confidence; counseling; electronic cigarette; knowledge; physicians.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • China
  • Counseling*
  • Electronic Nicotine Delivery Systems*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physicians / psychology*
  • Physicians / statistics & numerical data
  • Professional Competence
  • Vaping / psychology*