Beliefs, Practices, and Self-efficacy of US Physicians Regarding Smoking Cessation and Electronic Cigarettes: A National Survey.
BACKGROUND
We sought to assess physician knowledge/beliefs, self-efficacy, and experience/practice patterns surrounding smoking cessation and electronic cigarettes.


METHODS
An eight-page survey sent via US Postal service. The initial invitation included a $10 cash incentive and up to three invitations were sent. Fifteen hundred US physicians were identified with equal representation from primary care physicians (internal medicine and family practice), surgical care physicians (general surgeons and anesthesiologists), and pulmonologists.


RESULTS
Two hundred fourteen were not included in the analysis (183 non-deliverable, one deceased, 30 not practicing). 561/1286 (44%) remaining surveys were returned for analysis. Greater than 90% agreed that advising and assisting with smoking cessation is their responsibility; 86% advise and 65% assist their patients with smoking cessation more than 75% of the time. Approximately two-thirds of respondents report that their patients ask them about electronic cigarettes at least some of the time (≥25%); 58.4% report that they ask their patients about electronic cigarette use at least some of the time. Overall, 37.9% have at some point recommended electronic cigarettes to their patients that smoke, with 11.5% reporting recommending them at least 25% of the time. Surgical care providers appear less confident and less self-efficacious with smoking cessation, as well as with electronic cigarettes and appear less likely to endorse use of electronic cigarettes.


CONCLUSIONS
US physicians are frequently discussing electronic cigarettes in a clinical context and a substantial proportion of US physicians have recommended electronic cigarettes to their patients.


CONCLUSIONS
This study documents several important previously poorly characterized aspects of the role of electronic cigarettes in clinical care. The majority of US physicians are discussing electronic cigarettes in clinical contexts and a substantial proportion of US physicians have recommended electronic cigarettes to their patients. The extent of physician engagement on the topic of electronic cigarettes should be met with increased efforts to better characterize electronic cigarettes' appropriate role in smoking cessation and reduction.
Division of Allergy, Pulmonary, and Critical Care, Departments of Medicine, Vanderbilt University Medical Center, Nashville, TN.|Division of Allergy, Immunology, and Pulmonary, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.|Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN.
Andrew S
AS
Nickels
Mayo Clinic College of Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, MN.
David O
DO
Warner
Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
Sarah Michelle
SM
Jenkins
Division of General Internal Medicine, Mayo Clinic, Rochester, MN.|Biomedical Ethics Scholars Training Program, Mayo Clinic, Rochester, MN.|Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN.|Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN.
Jon
J
Tilburt
Division of General Internal Medicine, Mayo Clinic, Rochester, MN.|Nicotine Dependence Center, Mayo Clinic, Rochester, MN.
J Taylor
JT
Hays
D001291:Attitude of Health Personnel; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D020377:Self Efficacy; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014481:United States