title: E-cigarettes: online survey of UK smoking cessation practitioners.
abstract: BACKGROUND
  Use of e-cigarettes (inhalable vapour producing battery powered devices that aim to simulate tobacco cigarettes), is rising in a number of countries, but as yet none of these products are regulated as medicinal devices or available as smoking cessation treatments. Smokers seeking support from health professionals to stop smoking are interested in e-cigarettes and may be buying them to aid a quit attempt. Determining what smokers are asking, and what health professionals think about these products may have implications for smoking treatment services in a number of countries.
  
  
  METHODS
  Stop smoking service advisors, managers and commissioners in the United Kingdom were asked to take part in two surveys on e-cigarettes. Data was analysed from 587 practitioners who completed a survey in 2011 and 705 practitioners who completed a repeat survey in 2013. Responses to multiple choice questions and free text comments were analysed.
  
  
  RESULTS
  Responding practitioners reported that interest in, and use of, e-cigarettes is growing among adults seeking help to stop smoking in the UK. In 2013 91% of respondents reported that interest in e-cigarettes had grown in the past year and whilst in 2011, 2% of respondents reported a 'quarter to a half' of their clients saying that they were regularly using e-cigarettes, by 2013 this had increased to 23.5% (p < .001). Responding practitioners' views towards e-cigarettes became more positive between the first and second surveys (15% strongly agreed/agreed in 2011 that 'e-cigarettes are a good thing' rising to 26% in 2013). However, they continued to have concerns about the products. In particular, analysis of free text responses suggested practitioners were unsure about safety or efficacy for smoking cessation, and were worried that smokers may become dependent on the products. Practitioners were also aware of the potential of e-cigarettes to undermine smokers' willingness to use evidence-based methods to stop, and to challenge policies aiming to denormalise tobacco smoking.
  
  
  CONCLUSIONS
  Health professionals are asking for reliable and accurate information on e-cigarettes to convey to smokers who want to quit. Randomized controlled trials and ongoing surveillance of e-cigarette use and its consequences for smoking cessation rates and smoking treatment services are required.
authors.affiliation: Department for Health, University of Bath, Bath, UK ; UK Centre for Tobacco and Alcohol Studies, Nottingham, UK.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Hiscock
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, USA.
authors.forename: Maciej Lukasz
authors.initials: ML
authors.lastname: Goniewicz
authors.affiliation: UK Centre for Tobacco and Alcohol Studies, Nottingham, UK ; National Centre for Smoking Cessation and Training (NCSCT), London, UK ; Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
authors.forename: Andy
authors.initials: A
authors.lastname: McEwen
authors.affiliation: School of Applied Social Science, University of Stirling, Stirling, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Murray
authors.affiliation: Action on Smoking and Health, London, UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Arnott
authors.affiliation: Public Health England, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Dockrell
authors.affiliation: UK Centre for Tobacco and Alcohol Studies, Nottingham, UK ; Institute for Social Marketing, University of Stirling, Stirling, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Bauld
keywords: E-cigarettes; NHS stop smoking services; Practitioners