title: Healthcare staff attitudes towards the use of electronic cigarettes ('e-cigarettes') compared with a local trust policy.
abstract: BACKGROUND
  E-cigarette use has risen dramatically in recent years, despite uncertainty over long-term health effects and concerns regarding efficacy as a smoking cessation device. Currently, there is no legislation prohibiting use in public, though many trusts have extended the NHS Smokefree policy to include e-cigarettes. The successful implementation of such policy is, however, unclear.
  
  
  OBJECTIVE
  This study examined staff attitudes towards the use of e-cigarettes in a hospital environment with respect to enforcement of a local trust smoking policy.
  
  
  METHODS
  A total of 79 healthcare professionals working at South Tyneside District Hospital, South Shields, completed a written questionnaire regarding use of e-cigarettes, particularly views on use in public and on hospital premises. Factors influencing the likelihood of individuals to challenge the use of e-cigarettes were assessed.
  
  
  RESULTS
  In all, 45% of respondents thought that e-cigarettes should be allowed in public places, though a majority (62%) favoured use on hospital grounds compared to within hospital buildings (18%). Over 50% of respondents were unaware of trust policy relating to e-cigarettes and only 25% had ever challenged someone using a device. Roughly, one-third reported that they would still not challenge someone in future, despite being informed of trust policy. Fear of abuse was the most cited reason for not challenging. Expressed concerns of e-cigarette use related to fire risk, 'normalising' smoking behaviour and uncertainty of long-term effects.
  
  
  CONCLUSIONS
  Most staff do not enforce trust policy regarding e-cigarette use. This reflects variation in opinion over use, poor awareness of the policy itself and perceived barriers to implementation, including fear of abuse. Addressing these issues through staff education sessions may help successful future implementation.
authors: Clinical Teaching Fellow, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK.
authors: Benjamin J
authors: BJ
authors: Pippard
authors: Consultant Respiratory Physician, South Tyneside NHS Foundation Trust, South Tyneside, UK.
authors: Mark D
authors: MD
authors: Shipley
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D066300:Electronic Nicotine Delivery Systems; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D016134:Organizational Policy; D061845:Smoke-Free Policy; D013222:State Medicine; D011795:Surveys and Questionnaires
keywords: attitudes; e-cigarettes; healthcare; policy; smoking; staff