title: Healthcare providers' beliefs and attitudes about electronic cigarettes and preventive counseling for adolescent patients.
abstract: OBJECTIVE
  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.
authors: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: jkadis@live.unc.edu.
authors: Jessica K
authors: JK
authors: Pepper
authors: Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio.
authors: Annie-Laurie
authors: AL
authors: McRee
authors: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Melissa B
authors: MB
authors: Gilkey
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002648:Child; D003376:Counseling / Q000379:methods* / Q000706:statistics & numerical data; D066300:Electronic Nicotine Delivery Systems / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008910:Minnesota; D064424:Tobacco Use / Q000517:prevention & control* / Q000523:psychology
keywords: Adolescent health; Electronic cigarette; Electronic nicotine delivery system; Medical education; Nicotine; Smoking