Original article
Healthcare Providers' Beliefs and Attitudes About Electronic Cigarettes and Preventive Counseling for Adolescent Patients

https://doi.org/10.1016/j.jadohealth.2013.10.001Get rights and content

Abstract

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.

Section snippets

Methods

We surveyed a statewide sample of physicians and nurse practitioners who provide preventive care to preteens and adolescents ages 11–17 years. We identified potential participants through publicly available lists provided by the Minnesota Boards of Medical Practice and of Nursing. From these lists, we sampled providers in pediatric and family medicine specialties, excluding providers without e-mail addresses or Minnesota mailing addresses. Because our sampling frame included many providers who

Results

Most providers were female (71%) and practiced in a suburban setting (42%) (Table 1). Respondents included family medicine physicians (46%), pediatricians (20%), and nurse practitioners (34%). The average age was 48 years (SD 11 years), and most providers (59%) completed their clinical training prior to 2000.

Discussion

To our knowledge, this study is the first to examine healthcare providers' awareness of and attitudes about e-cigarettes and adolescents, an important emerging public health concern given the dramatic increase in use of e-cigarettes by U.S. adolescents between 2011 and 2012 [8]. Our findings suggest nearly all providers had heard of e-cigarettes, but most had learned about them from anecdotal sources such as patients, news stories, and advertisements, rather than through professional avenues.

Acknowledgments

This study was funded through a 2012 Young Investigator Award from the Academic Pediatric Association, supported by the Maternal and Child Health Bureau and the American Academy of Pediatrics (Federal Grant U04MC07853-03). The study was further supported by a NRSA in Primary Medical Care from HRSA (T32HP22239, PI: Borowsky); UNC Lineberger Cancer Control Education Program (R25 CA57726); and Clinical and Translational Science Institute grant support (UL1RR033183) to the University of Minnesota

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    Conflicts of interest: None

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