title: Primary healthcare provider knowledge, beliefs and clinic-based practices regarding alternative tobacco products and marijuana: a qualitative study.
abstract: Use prevalence of alternative tobacco products and marijuana has increased dramatically. Unfortunately, clinical guidelines have focused on traditional cigarettes with limited attention regarding these emerging public health issues. Thus, it is critical to understand how healthcare professionals view this issue and are responding to it. This qualitative study explored knowledge, beliefs and clinic-based practices regarding traditional and alternative tobacco products (cigar-like products, smokeless tobacco, hookah, e-cigarettes) and marijuana among rural and urban Georgia primary healthcare providers. The sample comprised 20 healthcare providers in primary care settings located in the Atlanta Metropolitan area and rural southern Georgia who participated in semi-structured interviews. Results indicated a lack of knowledge about these products, with some believing that some products were less harmful than traditional cigarettes or that they may be effective in promoting cessation or harm reduction. Few reported explicitly assessing use of these various products in clinic. In addition, healthcare providers reported a need for empirical evidence to inform their clinical practice. Healthcare providers must systematically assess use of the range of tobacco products and marijuana. Evidence-based recommendations or information sources are needed to inform clinical practice and help providers navigate conversations with patients using or inquiring about these products.
authors.affiliation: Department of Behavioral Sciences & Health Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA and.
authors.forename: Ta Misha S
authors.initials: TM
authors.lastname: Bascombe
authors.affiliation: Cancer Coalition of South Georgia, Albany, GA 31707, USA.
authors.forename: Kimberly N
authors.initials: KN
authors.lastname: Scott
authors.affiliation: Cancer Coalition of South Georgia, Albany, GA 31707, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Ballard
authors.affiliation: Department of Behavioral Sciences & Health Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA and.
authors.forename: Samantha A
authors.initials: SA
authors.lastname: Smith
authors.affiliation: Department of Behavioral Sciences & Health Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA and.
authors.forename: Winifred
authors.initials: W
authors.lastname: Thompson
authors.affiliation: Department of Behavioral Sciences & Health Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA and cjberg@emory.edu.
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Berg
mesh_terms: D001294:Attitude to Health; D002188:Cannabis / Q000009:adverse effects*; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D005845:Georgia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000523:psychology*; D000075387:Smoking Water Pipes; D062789:Tobacco Products / Q000009:adverse effects*; D014030:Tobacco, Smokeless / Q000009:adverse effects