title: Pediatrician Knowledge, Attitudes, and Practice Related to Electronic Cigarettes.
abstract: Electronic cigarettes (e-cigarettes) have grown rapidly in popularity, creating concerns for pediatricians and families. Evaluating pediatricians' understanding of e-cigarettes is an important first step in effectively addressing these products in practice. This qualitative study assesses pediatricians' knowledge, attitudes, and current clinical practices related to e-cigarettes.
  
  
  
  We conducted six focus groups with 37 pediatric clinicians in 2014. Groups were led by a trained facilitator using a semistructured discussion guide. Responses were recorded, transcribed, and coded to identify relevant themes.
  
  
  
  Pediatricians know that e-cigarettes generally contain nicotine and that adolescents and young adults are most likely to use them. However, most feel uninformed about the health effects of e-cigarettes and report wanting scientific evidence for safety or harm from credible sources. Pediatricians are skeptical of claims that e-cigarettes are safe, either for users or for those exposed to second-hand e-cigarette vapor or emissions. Participants noted that clinical conversations about e-cigarettes were rare, citing barriers including a lack of systematic screening, competing priorities during clinical visits, and, for some, limited confidence in their ability to address e-cigarettes during clinical encounters. No participants recommended e-cigarettes for cessation.
  
  
  
  Pediatricians feel poorly informed about e-cigarettes and are concerned about their potential health effects. While clinical discussions about e-cigarettes are rare, recent increases in their use leaves many clinicians wanting guidance about what to say to patients and families.
authors.affiliation: Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois. Electronic address: jgorzkowski@aap.org.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Gorzkowski
authors.affiliation: Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois.
authors.forename: Regina M
authors.initials: RM
authors.lastname: Whitmore
authors.affiliation: Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois.
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Kaseeska
authors.affiliation: Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois.
authors.forename: Janet K
authors.initials: JK
authors.lastname: Brishke
authors.affiliation: Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D002648:Child; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D000072143:Pediatricians; D010372:Pediatrics / Q000379:methods*; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D012907:Smoking / Q000009:adverse effects*
keywords: Electronic cigarettes; Pediatric practice; Qualitative Research; Tobacco