Physicians Reluctant to Recommend E-Cigarettes for Smoking Cessation, Survey Finds

Posted by: Vranks on March 28, 2017 Under: E-Cigarette Studies

According to a scientific paper published in the latest issue of the Annals of the American Thoracic Society journal, the vast majority of physicians would not recommend e-cigarettes to help their patients quit smoking, even after learning that FDA-approved solutions did not work for them.

In an effort to explore American physicians’ experiences discussing electronic cigarettes with their patients, study authors sent out an eight-page survey to a sample of 1,500 physicians included in the American Medical Association Masterfile. 390 of them responded to the survey, and the results clearly show that they would rather their patients keep smoking, rather than recommending they give vaping a try.

In addition to the question included in the survey, physicians were also asked to review the following clinical case vignette:

“A 27-year-old woman with moderate persistent asthma presents to establish care. She is on a moderate dose of combined inhaled fluticasone and salmeterol. Her symptoms are currently well controlled. She smokes. During your interview, she asks if she should use electronic cigarettes to help her quit smoking.”

Respondents were asked “Which of the following best describes your response to this patient’s question?”. They were given three response options:

I recommend this approach (recommend unconditionally)
I wouldn’t recommend this approach, but it’s up to you (tolerate)
Don’t use electronic cigarettes to quit smoking. I will prescribe a medication to help you quit smoking, such as nicotine patch or a pill (recommend against).

Approximately two thirds of respondents indicated that they would discourage patients from using e-cigarettes and prescribe FDA-approved smoking cessation medication instead, 18% reported that they would recommend e-cigs, and 14% said that they wouldn’t recommend them, but they would tolerate their use.

However, survey authors followed up the original scenario with a new one, where the patients tells the physicians that she has already tried quitting with the help of medication and asks if she should try quitting with the help of electronic cigarettes. Physicians are asked the same question as before, and offered the same three response options.

This time, 27% of physicians reported that they would recommend electronic cigarettes, 51% said that they wouldn’t recommend their use for smoking cessation, but would tolerate them if the patient wishes to try them, and 28% of them would not recommend electronic cigarettes.

So, for some reason, the vast majority of physicians in the U.S. would not recommend smokers try e-cigarettes, even if FDA-approved medication has proved ineffective in helping them quit. So what should they do, just keep on smoking?

Dr. Michael Siegel, of Tobacco Analysis, called the results of this survey appalling, but didn’t blame the physicians for their opinions. “They have been misled and confused by a major campaign of deception being waged by anti-tobacco groups and some health agencies, including the FDA and the CDC,” Dr. Siegel said. “These groups have lied to physicians and deceived them about the nature of e-cigarettes, their risks, and the relative risks of smoking compared to vaping.”

Yes, there is a lot of misinformation regarding electronic cigarettes and vaping, but these are physicians, they should know better, and I have a feeling that they actually do, but choose to support the pharmaceutical industry by promoting their products instead of e-cigarettes. With your patients’ only options after trying FDA-approved medication being to give e-cigarettes a try or keep on smoking, the best course of action seems obvious. And yet…

While I wholeheartedly agree that anti-vaping propaganda and misinformation play a big part in changing general perception of electronic cigarettes, as data clearly shows, when it come to trained physicians who are – or at least should be – very familiar with the dangers of smoking tobacco, I honestly think it is more than that.

Regardless of their motives, one thing is for sure, e-cigarettes won’t find much support in the doctor’s office. Not in the U.S. at least, because in countries like the UK, physicians have a completely different approach to vaping.