title: Lung cancer specialist physicians' attitudes towards e-cigarettes: A nationwide survey.
abstract: OBJECTIVE
  Despite a sharp increase in e-cigarette use, there is debate about whether e-cigarettes are a viable alternative for harm reduction, and the forms that regulation should take. Healthcare providers can be effective in offering guidance to patients and their families and shaping regulatory policy. We described lung cancer specialists' attitudes toward e-cigarettes and its regulation.
  
  
  METHODS
  We undertook a nationwide survey of pulmonologists, thoracic surgeons, medical and radiological oncologists who are members of Korean Association for Lung Cancer. Survey items included beliefs and attitudes toward e-cigarettes, attitudes toward e-cigarette regulation and preparedness on discussing e-cigarettes with their patients.
  
  
  RESULTS
  Most respondents believed that e-cigarettes are not safer than conventional tobacco cigarettes (75.7%) or smokeless tobacco (83.2%), and feared that discussing e-cigarettes with the patients would encourage use (65.4%). They did not consider it a smoking cessation treatment (78.3%), and thus would not recommend it to smokers who do not want to quit (82.2%) or who failed to quit with conventional smoking cessation treatment (74.1%). Most respondents supported all examples of e-cigarette regulations, including the safety and quality check (97.8%), warning label (97.8%), advertisement ban (95.1%), restriction of flavoring (78.4%), minimum purchasing age (99.5%), and restriction of indoor use (94.6%). Most learned about e-cigarettes from media and advertisements, or conversation with patients rather than through professional scientific resources, and reported discomfort when discussing e-cigarette with patients.
  
  
  CONCLUSIONS
  Lung cancer specialist physicians in Korea doubt the safety of e-cigarette and use of e-cigarette as smoking cessation treatment, and supported strict regulation. However, only 20% reported that they obtained information on e-cigarettes from the scientific literature and many lacked adequate knowledge based on scientific evidence, suggesting the need for better preparedness. Nevertheless, the views of professionals revealed from our study could help to develop clinical guidelines and regulatory guidance.
authors.affiliation: Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Korea.|Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul, Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.affiliation: Department of Radiation Oncology, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Young Il
authors.initials: YI
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul St. Mary Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, lnha University Hospital, Inha University College of Medicine, Incheon, Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: SeMin
authors.initials: S
authors.lastname: Chong
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Young Sik
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
authors.forename: Sang-Yun
authors.initials: SY
authors.lastname: Song
authors.affiliation: Medical Correspondent & Social Policy Desk, Donga-A Ilbo, Seoul, Korea.
authors.forename: Jin Han
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Korea.
authors.forename: Sei Hoon
authors.initials: SH
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
authors.forename: Myoung Kyu
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Deog Gon
authors.initials: DG
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Kosin University Medical College, Pusan, Korea.
authors.forename: Tae Won
authors.initials: TW
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea.
authors.forename: Ji Woong
authors.initials: JW
authors.lastname: Son
authors.affiliation: Department of Internal Medicine, lnha University Hospital, Inha University College of Medicine, Incheon, Korea.
authors.forename: Jeong-Seon
authors.identifier: http://orcid.org/0000-0003-2947-8369
authors.initials: JS
authors.lastname: Ryu
authors.affiliation: Department of Radiation Oncology, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Moon-June
authors.initials: MJ
authors.lastname: Cho
mesh_terms: D000328:Adult; D066300:Electronic Nicotine Delivery Systems / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D040261:Harm Reduction; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D000072103:Oncologists / Q000523:psychology*; D000072106:Pulmonologists / Q000523:psychology*; D056910:Republic of Korea; D012907:Smoking / Q000009:adverse effects / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000009:adverse effects; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology; D014030:Tobacco, Smokeless / Q000009:adverse effects