Knowledge and beliefs about electronic cigarettes among quitline cessation staff.
Smokers are asking health practitioners for guidance about using e-cigarettes as an aid to quitting. Several studies have surveyed physicians. However, in North America many smokers seek help from telephone quitlines rather than physicians. The objective of the current study was to assess quitline counselors' perceptions of e-cigarettes and what they tell callers about these products.



An online cross-sectional survey, conducted in 2014 with 418 quitline counselors in the U.S. and Canada, measured perceptions of e-cigarettes: (1) use as a quitting aid; (2) safety; (3) professional guidance given and organizational guidance received; (4) regulation. The response rate was 90.1%. Analyses included calculating standard errors and 95% confidence intervals around summary statistics.



Nearly 70% of counselors believed that e-cigarettes are not effective quitting aids. Most believed e-cigarettes are addictive (87%) and that secondhand exposure to vapor is harmful (71%). Counselors reported that callers ask for advice about e-cigarettes, but few counselors recommended e-cigarettes (4%). Counselors (97%) reported being instructed by quitline employers to explain to clients that e-cigarettes are not FDA-approved; 74% were told to recommend approved quitting aids instead. Most counselors (>87%) believed e-cigarettes should be regulated like cigarettes in terms of advertising, taxation, access by minors, and use in public places.



Quitline counselors view e-cigarettes as ineffective quitting aids, potentially dangerous, and in need of greater regulations. Counselors can influence how treatment seekers view e-cigarettes, therefore it is imperative that quitlines stay abreast of emerging data and communicate about these products in ways that best serve clients.
Department of Family Medicine and Public Health, UCSD, 9500 Gilman Drive, MC 0905, La Jolla, CA 92093, United States; Moores Cancer Center, UCSD, 9500 Gilman Drive, MC 0905, La Jolla, CA 92093, United States. Electronic address: scummins@ucsd.edu.
Sharon
S
Cummins
Mayo Clinic, 13400 E. Shea Blvd, MCCRB 2-205, Scottsdale, AZ 85259, United States. Electronic address: leischow.scott@mayo.edu.
Scott
S
Leischow
North American Quitline Consortium, 3219 E. Camelback Road, #416, Phoenix, AZ 85018, United States. Electronic address: lbailey@NAQuitline.org.
Linda
L
Bailey
Alere Wellbeing, Clinical and Behavioral Sciences, 999 3rd Ave Suite 2100, Seattle, WA 98104, United States. Electronic address: Terry.Bush@alere.com.
Terry
T
Bush
Alere Wellbeing, Clinical and Behavioral Sciences, 999 3rd Ave Suite 2100, Seattle, WA 98104, United States. Electronic address: Ken.wassum@alere.com.
Ken
K
Wassum
Moores Cancer Center, UCSD, 9500 Gilman Drive, MC 0905, La Jolla, CA 92093, United States. Electronic address: lcopeland@ucsd.edu.
Lesley
L
Copeland
Department of Family Medicine and Public Health, UCSD, 9500 Gilman Drive, MC 0905, La Jolla, CA 92093, United States; Moores Cancer Center, UCSD, 9500 Gilman Drive, MC 0905, La Jolla, CA 92093, United States. Electronic address: szhu@ucsd.edu.
Shu-Hong
SH
Zhu
D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D002983:Clinical Competence / Q000706:statistics & numerical data*; D000072117:Counselors / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems / Q000379:methods*; D005260:Female; D015277:Hotlines; D006801:Humans; D008297:Male; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D014481:United States
Electronic nicotine delivery device (ENDS); Information seeking behavior; Public health; Smoking cessation program; Tobacco use cessation products