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Cho YJ, Thrasher JF, Gravely S, Alberg A, Borland R, Yong HH, Cummings KM, Hitchman SC, Fong GT. Adult smokers' discussions about vaping with health professionals and subsequent behavior change: a cohort study. Addiction 2022; 117:2933-2942. [PMID: 35792058 PMCID: PMC10964167 DOI: 10.1111/add.15994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/07/2022] [Indexed: 11/27/2022]
Abstract
AIMS To measure the prevalence and changes in smokers' discussions with health professionals (HPs) about nicotine vaping products (NVPs) and HPs' recommendations about NVPs between 2016 and 2020, and their associations with tobacco product use transitions. DESIGN Cohort study using multinomial logistic regression analyses on data from waves 1 (2016), 2 (2018) and 3 (2020) from the International Tobacco Control Four Country Smoking and Vaping Surveys. SETTING Four countries with varying NVP regulatory environments: 'most restrictive' (Australia), 'somewhat restrictive' (Canada) and 'less restrictive' (England and the United States). PARTICIPANTS Adult exclusive daily smokers who did not report NVP use at the time of their baseline survey and had visited a HP in the last 12-24 months. Prevalence data came from 4125, 4503 and 4277 respondents, respectively, for each year. Longitudinal data were from 4859 respondents who participated in at least two consecutive surveys. MEASUREMENTS Prevalence of self-reported discussions with HPs and recommendations from HPs about NVPs. Longitudinal transitions from smoking to vaping (either exclusively or concurrently with smoking) and quitting (regardless of NVP uptake). FINDINGS The prevalence of NVP discussions was low among countries with varying regulatory environments and study waves (range = 1.4-6.2%). In 2020, a low percentage of smokers who discussed NVPs with a HP reported that their HPs recommended they use NVPs in the United States (14.7%), Australia (20.2%), Canada (25.7%), with a higher percentage in England (55.7%) where clinical guidelines for smoking cessation include NVPs. Compared with 12.0% of smokers who reported no discussion, 37.0% of those whose HPs recommended NVPs transitioned to vaping at follow-up. Transition to quitting was 9.6% with HPs' recommendation of NVPs versus 13.5% without discussion, a non-significant difference. CONCLUSIONS In Australia, Canada, England and the United States between 2016 and 2020, health professionals' discussions with smokers about nicotine vaping products (NVPs) were infrequent. NVP discussions were associated with NVP uptake, but not with quitting smoking.
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Affiliation(s)
- Yoo Jin Cho
- Department of Internal Medicine, Ohio State University, Columbus, OH, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Anthony Alberg
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ron Borland
- Cancer Council Victoria, Melbourne, VIC, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - K Michael Cummings
- Department of Psychiatry and Behavioural Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Sara C Hitchman
- Department of Communication and Media Research, University of Zurich, Zürich, Switzerland
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- Department of Communication and Media Research, University of Zurich, Zürich, Switzerland
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
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LeLaurin JH, Thrasher JF, Strayer SM, Malaty J, Kollath-Cattano C, Williams M, Nguyen OT, Kellner AM, Smith JM, Salloum RG. Feasibility of a primary care patient decision aid for smoking cessation with information about e-cigarettes. Prev Med Rep 2022; 26:101745. [PMID: 35251914 PMCID: PMC8892147 DOI: 10.1016/j.pmedr.2022.101745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/28/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022] Open
Abstract
Decision aids can promote shared decision making and behavior change and may be effective in helping patients quit smoking. Patients are increasingly using e-cigarettes for smoking cessation; however, little is known about the impact of including e-cigarette information in smoking cessation decision aids. Our objective was to assess the feasibility and acceptability of a smoking cessation decision aid including e-cigarette information. This study was conducted at one family medicine clinic in the United States. We used a pre-post design. In Phase I, the decision aid presented information about approved cessation methods. In Phase II, current e-cigarette users and patients with no intention of quitting received additional information on switching to e-cigarettes. We assessed the impact of the decision aids on quit attempts and abstinence, confidence and readiness to quit, confidence and readiness to switch to e-cigarettes, and patient satisfaction. We enrolled 60 patients in each phase (N = 120). Patients reported higher confidence and readiness to quit after viewing the decision aids and consulting with their physician (p < 0.01). Patients reported the decision aid helped prepare them to make a decision about quitting smoking and expressed satisfaction with the decision aid and clinician consultation. We did not observe an impact of including e-cigarette information. Smoking cessation decision aids are acceptable to patients and may promote behavior change. Future studies should explore the impact of providing patients e-cigarette information using larger sample sizes and rigorous designs. Further research is needed to identify strategies to promote shared decision-making regarding e-cigarettes.
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Affiliation(s)
- Jennifer H. LeLaurin
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Scott M. Strayer
- Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - John Malaty
- Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Maribeth Williams
- Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Oliver T. Nguyen
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Allie M. Kellner
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - James M. Smith
- Division of General Internal Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ramzi G. Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
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Selamoglu M, Erbas B, Kasiviswanathan K, Barton C. GP knowledge, attitudes, beliefs, and practices surrounding the prescription of e-cigarettes for smoking cessation: a protocol for a mixed-method systematic review. BJGP Open 2021; 5:BJGPO.2021.0091. [PMID: 34497095 PMCID: PMC9447306 DOI: 10.3399/bjgpo.2021.0091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) are being marketed to people who smoke (PWS) as a smoking cessation aid. GPs have an important role in providing patients with support to encourage them to quit smoking. The emergence and marketing of e-cigarettes as a smoking cessation alternative poses challenges to GPs in advising and supporting PWS to quit. AIM This systematic review aims to synthesise available evidence on the knowledge, attitudes, and perceptions of GPs about e-cigarettes as a smoking cessation aid. DESIGN & SETTING Mixed-methods study review including quantitative, qualitative, and mixed-methods studies of GPs in primary care settings. METHOD MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus, PsycINFO, and Embase databases will be searched to identify articles published between 1 January 2003 and 30 June 2021. A Google search will be conducted to identify grey literature. Two independent reviewers will screen abstracts for relevance and full-text studies. Articles will be appraised for quality using the Mixed Methods Appraisal Tool (MMAT) and a Preferred Reporting Items for Systematic Reviews, and Meta-Analysis (PRISMA) diagram will illustrate the flow of articles and reasons for exclusion. An evidence synthesis method will be employed and guided by the Theory of Planned Behaviour (TPB). A descriptive qualitative synthesis of the findings will be reported. CONCLUSION Findings will provide a synthesis of current evidence regarding the knowledge, attitudes, and perceptions among GPs of e-cigarettes as a smoking cessation aid. This information will be useful to guide future research on the needs of GPs in advising and supporting patients to quit smoking. It will also assist in the development of health policy and guidelines on the role and place of e-cigarettes as a smoking cessation aid.
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Affiliation(s)
- Melis Selamoglu
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bircan Erbas
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | | | - Chris Barton
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Primary Care Physician Perspectives on Recommending E-cigarettes to Smokers: a Best-Worst Discrete Choice Experiment. J Gen Intern Med 2021; 36:3353-3360. [PMID: 33523343 PMCID: PMC8606483 DOI: 10.1007/s11606-021-06615-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Recent clinical trials suggest that e-cigarettes may be more effective for smoking cessation than traditional cessation aids, yet primary care physician (PCP) practices regarding e-cigarette recommendations for smokers have not been studied in-depth. OBJECTIVE To identify factors influencing PCP recommendation of e-cigarettes for smoking cessation. DESIGN Discrete choice experiment and survey. PARTICIPANTS Florida PCPs. MEASURES The survey included a discrete choice experiment in which PCPs indicated whether they would recommend e-cigarettes for each of 8 hypothetical patient profiles with the following contrasting characteristics: e-cigarette use, interest in approved cessation methods, smoking intensity, prior experience with approved cessation medications, quit intention, age, and comorbidity. Responses were summarized using descriptive statistics and standardized scores (SS). KEY RESULTS The sample (n = 216) was predominately male (76%), white (66%), and non-Hispanic (78%), and most respondents had held their medical degree for 20+ years (77%). The response rate was 28.7%. Most PCPs thought e-cigarettes were at least somewhat effective for smoking cessation (66%) and lowering disease risk (65%); 31% perceived e-cigarettes to be equally/more effective than traditional cessation aids. PCPs were split regarding whether e-cigarettes were less (50%) or equally harmful (38%) as cigarettes. Yet, few were very confident in their ability to counsel patients on e-cigarettes risks (27%) or benefits (15%). PCPs recommended e-cigarettes in 27% of patient profiles they evaluated. The most important factors influencing the decision to recommend or not recommend e-cigarette were patients' prior use of nicotine replacement therapy with (SS = 0.22, 95% CI = 0.17-0.27) and without use of other medications for cessation (SS = 0.18, 95% CI = 0.13-0.23), and being middle age (50 years old) with chronic obstructive pulmonary disease (SS = 0.16, 95% CI = 0.10-0.23). CONCLUSIONS Considering the increased patient use of e-cigarettes and increasing use for cessation, this study highlights the need for guidelines and education to aid PCPs' counseling of patients about e-cigarette use.
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Alzahrani SH, Alghamdi RA, Almutairi AM, Alghamdi AA, Aljuhani AA, ALbalawi AH. Knowledge and Attitudes Among Medical Students Toward the Clinical Usage of e-Cigarettes: A Cross-Sectional Study in a University Hospital in Saudi Arabia. Risk Manag Healthc Policy 2021; 14:1969-1984. [PMID: 34017206 PMCID: PMC8131966 DOI: 10.2147/rmhp.s302309] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background To assess knowledge and attitudes about e-smoking among undergraduate medical students, specifically focused on favorable view of therapeutic e-cigarette use for smoking cessation or harm reduction. Methods This cross-sectional study included medical students at King Abdulaziz University, Saudi Arabia. A six-item subscale was used to explore knowledge and attitudes about the therapeutic use of e-cigarettes, measuring participants' likelihood of favoring such use. A four-item questionnaire measured confidence and importance of being educated about smoking and e-smoking, in addition to sources of knowledge about e-cigarettes. Results A total of 399 students participated. Smoking history included current smokers (19.8%) and ex-smokers (6.5%), while e-cigarettes were tried by 36.6% and are currently used by 11.5%. A minority (13.5%) believed that e-cigarettes are FDA-approved for smoking cessation, while approximately one-third believed e-smoking lowers cancer risks (31.1%) and could help with smoking cessation (31.1%). Further, 35.9% agreed or strongly agreed that e-cigarettes are better for patients than tobacco products, and 17.5% were likely to recommend e-smoking to their patients for smoking cessation. Reliability of the six-item scale showed Cronbach's alpha = 0.676, which was enhanced to 0.746 after deletion of one item about addictiveness. Using the corrected five-item scale, 23.6% of the participants would favor therapeutic use of e-cigarettes. Conclusion We observed several misconceptions about addictiveness and inadequate awareness about e-cigarettes' harmful effects, leading to non-scientific opinions about its therapeutic use for harm reduction or in smoking cessation. Academic programs around this topic should be updated in accordance with majority expert recommendations.
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Affiliation(s)
- Sami H Alzahrani
- Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rawan A Alghamdi
- Ibn Sina National College for Medical Studies, Jeddah, Saudi Arabia
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Kollath-Cattano C, Thrasher JF, Salloum RG, Albano AW, Jindal M, Durkin M, Strayer SM. Evaluation of a smoking cessation patient decision aid that integrates information about e-cigarettes. Nicotine Tob Res 2021; 23:1880-1888. [PMID: 33984145 DOI: 10.1093/ntr/ntab095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/10/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smokers increasingly use e-cigarettes to try to quit smoking, even more than recommended cessation methods. However, few smokers discuss the range of cessation options with their physicians. Decision aids can inform smokers about smoking cessation options, including evidence about e-cigarettes, and encourage smokers to engage in shared decision making with their physician. This study aimed to evaluate a smoking cessation decision aid that included e-cigarette risks and benefits. METHODS Adult smokers were recruited from primary care clinics for two research phases: 1. usability and acceptability testing of the decision aid (n=37); and 2. pre/post study that compared usual care (n=90) with implementation of the decision aid in clinics (n=90). For the latter, outcome measures included frequency of clinical discussions of readiness to quit, methods to quit in general, and of specific cessation methods, in addition to decisional conflict, communication satisfaction, and overall patient satisfaction. RESULTS Smokers indicated high usability and acceptability of the decision aid. In the pre/post evaluation, decision aid implementation was associated with higher rates of smokers: being asked if they were ready to quit smoking (89% vs. 67%, respectively; p<0.001); discussing methods for smoking cessation in general (81% vs. 48%; p<0.001); and discussing specific cessation methods (NRT 55% vs. 26%, p<0.001; prescription medications 26% vs. 12%, p=0.022). Decision aid use was also associated with higher overall patient satisfaction with the physician visit. CONCLUSIONS Smoking cessation decision aids that incorporate information about e-cigarettes are acceptable among smokers and can lead to evidence-based clinical discussions about smoking cessation. IMPLICATIONS Smokers use e-cigarettes more than recommended cessation methods when they are trying to quit smoking, yet few physicians discuss the risks and benefits of e-cigarettes with their patients who smoke. This study presents preliminary findings about the feasibility and usability of a clinically based iPad-delivered smoking cessation decision aid that integrates information about e-cigarettes. Although promising, further research with randomized designs, larger samples, and longer-term follow-up is needed to determine whether this type of intervention can effectively promote cessation of all tobacco products and, for those not ready to quit smoking, the use of e-cigarettes for harm reduction.
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Affiliation(s)
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville
| | | | - Meenu Jindal
- Department of Internal Medicine, Prisma Health, Greenville
| | - Martin Durkin
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia
| | - Scott M Strayer
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond
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Jackson SE, Garnett C, Brown J. Prevalence and correlates of receipt by smokers of general practitioner advice on smoking cessation in England: a cross-sectional survey of adults. Addiction 2021; 116:358-372. [PMID: 32648976 PMCID: PMC8432152 DOI: 10.1111/add.15187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/19/2020] [Accepted: 07/07/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Advice from a general practitioner (GP) can encourage smokers to quit. This study aimed to estimate the prevalence and correlates of receipt of GP advice on smoking, what type of advice and support was offered and characteristics and quitting activity associated with different types of advice. DESIGN/SETTING Data were collected between 2016 and 2019 in a series of monthly cross-sectional surveys of representative samples of the adult population in England. PARTICIPANTS A total of 11 588 past-year smokers. MEASUREMENTS Participants reported whether they had received advice or offer of support for smoking cessation from their GP in the last year. Socio-demographic and behavioural characteristics and past-year quit attempts and cessation were also recorded. FINDINGS One in two [47.2%, 95% confidence interval (CI) = 46.1-48.3%] past-year smokers who reported visiting their GP in the last year recalled receiving advice on smoking, and one in three (30.1%, 95% CI = 29.1-31.1%) reported being offered cessation support. The most common form of support offered was stop smoking services (16.5%, 95% CI = 15.7-17.3%) followed by prescription medication (8.1%, 95% CI = 7.5-8.7%); 3.7% (95% CI = 3.3-4.1%) reported having been recommended to use e-cigarettes. Smokers who were older, non-white, more addicted, and smoked five or more cigarettes/day had consistently higher odds of receiving advice or support. There were some differences by region, housing tenure, presence of children in the home and high-risk drinking in the types of advice/support received. There were no significant differences by sex, occupational social grade, disability, type of cigarettes smoked, or survey year. Advice with any offer of support was associated with higher odds of attempting to quit than advice alone [adjusted odds ratio (ORadj ) = 1.52, 95% CI = 1.30-1.76]. Advice alone was associated with higher odds of quit attempts than no advice in smokers with higher (ORadj = 1.34, 95% CI = 1.10-1.64) but not lower occupational social grade (ORadj = 0.90, 95% CI = 0.75-1.08). CONCLUSIONS In England, a minority of smokers receive support from their GP to stop smoking. Those who do are more likely to be older, non-white and more addicted to cigarettes. Advice plus offer of support appears to be associated with increased odds of making a quit attempt, while advice without offer of support appears only to be associated with increased odds of making a quit attempt in higher occupational social grade smokers.
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Affiliation(s)
- Sarah E. Jackson
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Claire Garnett
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Jamie Brown
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
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Alcalá HE, Shimoga SV. It Is About Trust: Trust in Sources of Tobacco Health Information, Perceptions of Harm, and Use of E-Cigarettes. Nicotine Tob Res 2020; 22:822-826. [PMID: 30715455 DOI: 10.1093/ntr/ntz004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 01/14/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Recent research has highlighted disparities in people who perceive as trustworthy sources of e-cigarette health information. Research has yet to examine if trusting a particular source of information is associated with use of e-cigarettes or perceptions of e-cigarette harm. We use a nationally representative survey of American adults to address these gaps in knowledge. METHODS This study used data from the Health Information National Trends Survey (N = 3738). Logistic regression models were used to calculate odds of ever using e-cigarettes and perceived health harm of e-cigarettes. Trust in seven different sources of e-cigarette health information served as the independent variables. Models accounted for confounders. RESULTS Trusting religious organizations "a lot" as sources of e-cigarette health information was associated with lower odds of ever using e-cigarettes and with lower odds of perceiving e-cigarettes as less harmful than conventional cigarettes. Trusting e-cigarette companies "a lot" as sources of e-cigarette health information was associated with lower odds of viewing e-cigarettes as harmful to health. CONCLUSION Trusting health information about e-cigarettes from sources in the medical or public health field was not associated with lower use of e-cigarettes or viewing e-cigarettes as more harmful. Trusting health information from e-cigarette companies yielded perceptions of e-cigarette harm that are consistent with messaging provided by these companies. IMPLICATIONS As use of e-cigarettes continues to climb, leveraging different modes of health communication will be critical to both discourage e-cigarette use among never-smokers and, potentially, to encourage use of e-cigarettes as an option to achieve smoking cessation or reduce the harm of tobacco products. Our findings suggest that religious organizations may be helpful in communicating anti-e-cigarette messages.
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Affiliation(s)
- Héctor E Alcalá
- Department of Family, Population, and Preventive Medicine.,Program in Public Health, Stony Brook University, Stony Brook, NY
| | - Sandhya V Shimoga
- Department of Health Care Administration, California State University Long Beach, Long Beach, CA
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Gallegos-Carrillo K, Barrientos-Gutiérrez I, Arillo-Santillán E, Zavala-Arciniega L, Cho YJ, Thrasher JF. Health Professionals' Counseling about Electronic Cigarettes for Smokers and Vapers in a Country That Bans the Sales and Marketing of Electronic Cigarettes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020442. [PMID: 31936477 PMCID: PMC7013470 DOI: 10.3390/ijerph17020442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/20/2019] [Accepted: 01/08/2020] [Indexed: 12/18/2022]
Abstract
This study describes the prevalence and correlates of adult smokers’ discussions about electronic cigarettes (e-cigarettes) with health professionals (HPs), including whether these discussions may lead smokers and vapers to use e-cigarettes for smoking cessation. Methods: We analyzed data from an online survey of Mexican smokers recruited from a consumer panel for marketing research. Participants who had visited an HP in the prior four months (n = 1073) were asked about discussions of e-cigarettes during that visit and whether this led them to try to quit. Logistic models regressed these variables on socio-demographics and tobacco use-related variables. Results: Smokers who also used e-cigarettes (i.e., dual users) were more likely than exclusive smokers to have discussed e-cigarettes with their HP (adjusted odds ratio (AOR) = 3.96; 95% C.I. 2.73, 5.74), as were those who had recently attempted to quit smoking (AOR = 1.89; 95% C.I. 1.33, 2.7). Of smokers who had discussed e-cigarettes, 53.3% reported that the discussion led them to use e-cigarettes in their quit attempt. Also, dual users (AOR = 2.6; 95% C.I. 1.5, 4.5) and daily smokers (>5 cigarettes per day) (AOR = 3.62; 95% C.I. 1.9, 6.8) were more likely to report being led by their HP to use e-cigarettes in the quit attempt compared to exclusive smokers and non-daily smokers, respectively. Conclusions: Discussions between HP and smokers about e-cigarettes were relatively common in Mexico, where e-cigarettes are banned. These discussions appear driven by the use of e-cigarettes, as well as by greater smoking frequency and intentions to quit smoking.
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Affiliation(s)
- Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit, Mexican Institute of Social Security, Cuernavaca, Morelos 62000, Mexico
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico;
- Correspondence: (K.G.-C.); (J.F.T.); Tel.: +52-777-100-1364 (K.G.-C.); +1-803-777-4862 (J.F.T.)
| | - Inti Barrientos-Gutiérrez
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico;
| | - Edna Arillo-Santillán
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico;
- School of Demography, The Australian National University, Canberra, Australia/Tobacco Research Department, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico
| | | | - Yoo Jin Cho
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - James F. Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico;
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
- Correspondence: (K.G.-C.); (J.F.T.); Tel.: +52-777-100-1364 (K.G.-C.); +1-803-777-4862 (J.F.T.)
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Gravely S, Thrasher JF, Cummings KM, Ouimet J, McNeill A, Meng G, Lindblom EN, Loewen R, O’Connor RJ, Thompson ME, Hitchman SC, Hammond D, Heckman BW, Borland R, Yong HH, Elton-Marshall T, Bansal-Travers M, Gartner C, Fong GT. Discussions between health professionals and smokers about nicotine vaping products: results from the 2016 ITC Four Country Smoking and Vaping Survey. Addiction 2019; 114 Suppl 1:71-85. [PMID: 30548374 PMCID: PMC6559875 DOI: 10.1111/add.14527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS Debate exists about whether health professionals (HPs) should advise smokers to use nicotine vaping products (NVPs) to quit smoking. The objectives were to examine in four countries: (1) the prevalence of HP discussions and recommendations to use an NVP; (2) who initiated NVP discussions; (3) the type of HP advice received about NVPs; and (4) smoker's characteristics related to receiving advice about NVPs. DESIGN Cross-sectional study using multivariable logistic regression analyses on weighted data from the 2016 ITC Four Country Smoking and Vaping Survey (ITC 4CV1). SETTING Four countries with varying regulations governing the sale and marketing of NVPs: 'most restrictive' (Australia), 'restrictive' (Canada) or 'less restrictive' (England and United States). PARTICIPANTS A total of 6615 adult smokers who reported having visited an HP in the last year (drawn from the total sample of 12 294 4CV1 respondents, of whom 9398 reported smoking cigarettes daily or weekly). Respondents were from the United States (n = 1518), England (n = 2116), Australia (n = 1046), and Canada (n = 1935). MEASUREMENTS Participants' survey responses indicated if they were current daily or weekly smokers and had visited an HP in the past year. Among those participants, further questions asked participants to report (1) whether NVPs were discussed, (2) who raised the topic, (3) advice received on use of NVPs and (4) advice received on quitting smoking. FINDINGS Among the 6615 smokers who visited an HP in the last year, 6.8% reported discussing NVPs with an HP and 2.1% of smokers were encouraged to use an NVP (36.1% of those who had a discussion). Compared with Australia (4.3%), discussing NVPs with an HP was more likely in the United States [8.8%, odds ratio (OR) = 2.15, 95% confidence interval (CI) = 1.41-3.29] and Canada (7.8%, OR = 1.87, 95% CI = 1.26-2.78). Smokers in Australia were less likely to discuss NVPs than smokers in England (6.2%), although this was not statistically significant (OR = 1.47, 95% CI = 0.98-2.20). Overall, the prevalence of HPs recommending NVPs was three times more likely in the United States than in Australia (OR = 3.07, 95% CI = 1.45-6.47), and twice as likely in Canada (OR = 2.28, 95% CI = 1.06-4.87) than in Australia. Australia and England did not differ (OR = 1.76, 95% CI = 0.83-3.74). Just over half (54%) of respondents brought up NVPs themselves; there were no significant differences among countries. CONCLUSIONS Discussions in Australia, Canada, England, and the United States between smokers and health professionals about nicotine vaping products appear to be infrequent, regardless of the regulatory environment. A low percentage of health professionals recommended vaping products. This was particularly evident in Australia, which has the most restrictive regulatory environment of the four countries studied.
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Affiliation(s)
- Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Tobacco Research Department, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Ann McNeill
- King's College London, Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Gang Meng
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Eric N. Lindblom
- O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
| | - Ruth Loewen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Richard J. O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Sara C. Hitchman
- King's College London, Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Bryan W. Heckman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Ron Borland
- The Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Hua-Hie Yong
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Coral Gartner
- School of Public Health, Faculty of Medicine and Queensland Alliance for Environmental Health Sciences, The University of Queensland, The Public Health Building, Herston, QLD, Australia
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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11
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Kollath-Cattano C, Dorman T, Albano AW, Jindal M, Strayer SM, Thrasher JF. E-cigarettes and the clinical encounter: Physician perspectives on e-cigarette safety, effectiveness, and patient educational needs. J Eval Clin Pract 2019; 25:761-768. [PMID: 30784164 DOI: 10.1111/jep.13111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Christy Kollath-Cattano
- Department of Health and Human Performance, College of Charleston, Charleston, South Carolina
| | - Tyler Dorman
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | - Andrew W Albano
- Department of Family Medicine, Prisma Health, University of South Carolina School of Medicine Greenville, Greenville, South Carolina
| | - Meenu Jindal
- Internal Medicine Clinic, Prisma Health Upstate, Greenville, South Carolina
| | - Scott M Strayer
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
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DeHart WB, Mellis AM, Kaplan BA, Pope DA, Bickel WK. The Experimental Tobacco Marketplace: Narratives engage cognitive biases to increase electronic cigarette substitution. Drug Alcohol Depend 2019; 197:203-211. [PMID: 30849645 PMCID: PMC6447076 DOI: 10.1016/j.drugalcdep.2019.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Experimental Tobacco Marketplace (ETM) is a digital storefront in which participants can purchase tobacco products using an account balance that reflects their typical tobacco product purchasing. The ETM is also an ideal resource to investigate the harm-reduction potential of alternative nicotine products such as e-cigarettes. In a series of experiments, we explored the effects of harm-reduction narratives that encouraged e-cigarette substitution of conventional cigarettes in the ETM. These narratives incorporated different cognitive biases in order to determine which strategy is most effective. METHODS In both experiments, participants, recruited from Amazon Mechanical Turk, read a narrative about a friend that either falls ill or faces financial difficulties and then made purchases in the ETM. Some of these narratives specifically incorporated different cognitive biases including trusting authority. Across ETM trials, the price of conventional cigarettes increased while the price of the alternative products, including e-cigarettes, remained constant. RESULTS Across both experiments, a general pattern emerged supporting the effectiveness of narratives in increasing e-cigarette purchasing. Importantly, from a harm-reduction perspective, this increase in e-cigarette substitution frequently corresponded with a decrease in conventional cigarette purchasing. CONCLUSIONS Narratives can decrease conventional cigarette and increase e-cigarette purchasing in an ETM that mimics real-world marketplaces. Invoking different cognitive biases may bolster this effect. Narratives can be a valuable harm-reduction tool because they are cost-effective, can be widely disseminated, and can be personalized to individuals.
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Affiliation(s)
- William Brady DeHart
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA.
| | - Alexandra M Mellis
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA.
| | - Brent A Kaplan
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA.
| | - Derek A Pope
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA.
| | - Warren K Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA; Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA; Department of Psychology, Virginia Tech, Blacksburg, VA, USA; Department of Neuroscience, Virginia Tech, Blacksburg, VA, USA; Faculty of Health Sciences, Virginia Tech, Blacksburg, VA, USA.
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13
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Mumford EA, Stillman FA, Tanenbaum E, Doogan NJ, Roberts ME, Wewers ME, Chelluri D. Regional Rural-Urban Differences in E-Cigarette Use and Reasons for Use in the United States. J Rural Health 2018; 35:395-404. [PMID: 30430643 DOI: 10.1111/jrh.12333] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To determine whether there are rural/urban differences in e-cigarette use and reasons for use that vary across the 10 Health & Human Services (HHS) regions. METHODS Age-adjusted bivariate and multivariable analyses were conducted for n = 225,413 respondents to the 2014-2015 Tobacco Use Supplement-Current Population Survey to estimate the prevalence of e-cigarette use. Reasons for e-cigarette use were collected from n = 16,023 self-respondents who reported ever using e-cigarettes. FINDINGS While nationally rural residents appeared more likely to use e-cigarettes, adjusted results indicated that current e-cigarette use was significantly less likely across the northern and western regions (New England, East North Central, Heartland, North Central Mountain, Northwest, and Southwest Pacific regions). Reasons for e-cigarette use differed by urban/rural status and region; for example, the rationale to use e-cigarettes as a smoking cessation aid was significantly more common among rural compared to urban adults in the New England and New York/New Jersey regions, but less common in the Southeast. CONCLUSIONS For several regions, there were no significant rural/urban differences in e-cigarette use and reasons for use. Yet those regions that present differences face the need to develop public health approaches to minimize urban/rural disparities in health education, services, and outcomes related to tobacco use, particularly where access to health care is limited. Public health campaigns and guidance for clinical care within HHS regions should be tailored to reflect regional differences in beliefs about e-cigarettes.
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Affiliation(s)
- Elizabeth A Mumford
- Public Health Research, NORC at The University of Chicago, Bethesda, Maryland
| | - Frances A Stillman
- Public Health Research, NORC at The University of Chicago, Bethesda, Maryland
| | - Erin Tanenbaum
- Statistics and Methodology, NORC at The University of Chicago, Bethesda, Maryland
| | - Nathan J Doogan
- Ohio Colleges of Medicine Government Resource Center, The Ohio State University, Columbus, Ohio
| | - M E Roberts
- Division of Health Behavior & Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio
| | - M E Wewers
- Division of Health Behavior & Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio
| | - Devi Chelluri
- Statistics and Methodology, NORC at The University of Chicago, Bethesda, Maryland
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14
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Salloum RG, Lee J, Porter M, Dallery J, McDaniel AM, Bian J, Thrasher JF. Evidence-based tobacco treatment utilization among dual users of cigarettes and E-cigarettes. Prev Med 2018; 114:193-199. [PMID: 30026117 DOI: 10.1016/j.ypmed.2018.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/04/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
Dual users of e-cigarettes and cigarettes may represent a unique and receptive population for evidence-based tobacco dependence treatment. We measured the frequency of quit attempts during the past year, and the use of evidence-based tobacco dependence treatments (i.e., behavioral and/or pharmacological treatments), among adult smokers who are current e-cigarette users (dual users) compared with those who do not use e-cigarettes (exclusive smokers). Data were analyzed from the 2015 National Health Interview Survey. Multivariate-adjusted regression models were used to examine the correlates of tobacco treatment use among adult smokers, comparing current e-cigarette users with those who did not use e-cigarettes, stratifying by age group, and adjusting for sociodemographic characteristics. Analyses were based on 5415 adult current cigarette smokers. Compared to exclusive smokers, dual users were more likely to report a quit attempt in the past year among adults <65 years: 18-24 years (odds ratio [OR] = 2.25), 25-44 years (OR = 1.60), and 45-64 years (OR = 1.96). With the exception of adults ≥65 years, dual users reported low rates of using combination (behavioral and pharmacological) treatments that were not statistically different from exclusive smokers: 18-24 years (0.1% vs. 2.1%, respectively), 25-44 years (4.3% vs. 4.7%), and 45-64 years (3.0% vs. 8.3%). Despite higher likelihood for dual users to make a quit attempt, their use of evidence-based tobacco treatment is low, similar to exclusive smokers. Dual users of cigarettes and e-cigarettes represent a prime target for interventions to expand access and utilization of evidence-based tobacco use treatments.
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Affiliation(s)
- Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - JuHan Lee
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, United States of America
| | - Maribeth Porter
- Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Jesse Dallery
- Department of Psychology, College of Liberals Arts and Sciences, University of Florida, Gainesville, FL, United States of America
| | - Anna M McDaniel
- Department of Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, FL, United States of America
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
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15
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Farrimond H, Abraham C. Developing E-cigarette friendly smoking cessation services in England: staff perspectives. Harm Reduct J 2018; 15:38. [PMID: 30075724 PMCID: PMC6076389 DOI: 10.1186/s12954-018-0244-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Public health leadership in England has taken a distinctive international stance by identifying the potential public health benefit of e-cigarettes for smoking cessation. This includes the development of a ground-breaking set of national guidelines for developing e-cigarette friendly stop smoking services. However, little is known about the views of staff engaged within these services and whether or how such services are becoming e-cigarette friendly. This study aimed to investigate the uptake and usage of e-cigarette guidance, from the perspective of those enacting tobacco cessation interventions 'on the ground'. METHODS Qualitative semi-structured interviews were conducted with 25 cessation service staff, including advisors (n = 15), managers (n = 5) and commissioners (n = 5) from eight different services in the South-West of England, UK. A thematic analysis of the transcripts was conducted using NVivo software. RESULTS Although some stop smoking services labelled themselves e-cigarette friendly, there was no consensus over what this should entail. For some, this meant active engagement, such as working with local vape shops, and in the case of one service, offering e-cigarettes through a voucher scheme to disadvantaged groups. For others, an e-cigarette friendly service was conceptualized in a passive sense, as one which welcomed service users using e-cigarettes. Many services did not use the 'e-cigarette friendly' claim in their branding or promotional material. Several discursive themes underlay differing staff attitudes. Those more reluctant to engage framed this in terms of their 'duty of care', with concerns focusing on the addictiveness of nicotine, lack of medically licensed product and ongoing scientific controversy. Those motivated to engage drew on a discourse of social justice goals and 'doing things differently' in relation to lower socio-economic status smokers, those with mental health issues and other vulnerable groups. Strong public health leadership was also identified as a key factor in changing staff attitudes towards e-cigarettes. CONCLUSIONS On-the-ground enactment of e-cigarette friendly services is varied as well as reflective of the wider policy and regulatory environment. Although the context of English stop smoking services is one of austerity and change, there are opportunities for active engagement with e-cigarettes to achieve overall cessation goals. For this to occur, training, policy consistency and sharing best practice are needed.
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Affiliation(s)
- Hannah Farrimond
- EGENIS (Exeter Centre for the Study of Life Sciences), Department of Sociology, Philosophy and Anthropology, University of Exeter, FF16, Byrne House, Streatham Campus, Exeter, EX4 4PJ UK
| | - Charles Abraham
- School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, 3010 Australia
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Abstract
OBJECTIVE The purposes of this article are to detail the experience of a single-center academic institution in applying the patient-centered approach to a lung cancer screening program and to examine how this approach can expand to other aspects of follow-up imaging of lung nodules. CONCLUSION As the practice of patient-centered radiology gains attention, diagnostic radiologists are findings new ways to become more involved in patient care. A lung cancer screening program is one opportunity for radiologists to consult with and educate patients.
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Singh B, Hrywna M, Wackowski OA, Delnevo CD, Jane Lewis M, Steinberg MB. "Knowledge, recommendation, and beliefs of e-cigarettes among physicians involved in tobacco cessation: A qualitative study". Prev Med Rep 2017; 8:25-29. [PMID: 28831370 PMCID: PMC5555092 DOI: 10.1016/j.pmedr.2017.07.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/13/2017] [Accepted: 07/31/2017] [Indexed: 11/24/2022] Open
Abstract
Physicians are rated the most trustworthy source of information for smokers and thus play an increasing role in disseminating information on e-cigarettes to patients. Therefore, it is important to understand what is currently being communicated about e-cigarettes between physicians and patients. This study explored the knowledge, beliefs, communication, and recommendation of e-cigarettes among physicians of various specialties. Semi-structured interviews were conducted in early 2016 with 35 physicians across five different specialties. Interviews were transcribed and coded for the following deductive themes: (1) tobacco cessation recommendation practices, (2) knowledge of e-cigarettes, (3) communication of e-cigarettes with patients, (4) recommendation of e-cigarettes, and (5) general beliefs about e-cigarettes. Physicians across all specialties reported having conversations with patients about e-cigarettes. Conversations were generally prompted by the patient inquiring about e-cigarettes as a cessation method. Overall, physicians felt there was a lack of information on the efficacy and long term health effects but despite lack of evidence, generally did not discourage patients from trying e-cigarettes as a cessation device. Although physicians did not currently recommend e-cigarettes over traditional cessation methods, they were open to recommending e-cigarettes in the future if adequate data became available suggesting effectiveness. Patients are inquiring about e-cigarettes with physicians across various specialties. Future research should continue to study physicians' perceptions/practices given their potential to impact patient behavior and the possibility that such perceptions may change over time in response to the evidence-base on e-cigarettes. Physicians across specialties are having conversations with patients about ecigs. Generally did not discourage patients from trying ecigs as a cessation device. Physicians open to recommending ecigs for cessation in the future. Adolescent use major cause of concern for physicians.
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Affiliation(s)
- Binu Singh
- Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, 683 Hoes Lane West Piscataway, NJ 08854, United States
| | - Mary Hrywna
- Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, 683 Hoes Lane West Piscataway, NJ 08854, United States
| | - Olivia A Wackowski
- Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, 683 Hoes Lane West Piscataway, NJ 08854, United States
| | - Cristine D Delnevo
- Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, 683 Hoes Lane West Piscataway, NJ 08854, United States
| | - M Jane Lewis
- Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, 683 Hoes Lane West Piscataway, NJ 08854, United States
| | - Michael B Steinberg
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, 125 Paterson Street, New Brunswick, NJ 08901, United States
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