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Communication Between US Physicians and Patients Regarding Electronic Cigarette Use
IMPORTANCE: Physicians play a primary role in patient smoking cessation, yet their communication regarding e-cigarettes is not well understood. OBJECTIVE: To assess physician-patient communication regarding e-cigarettes. DESIGN, SETTING, AND PARTICIPANTS: A national cross-sectional survey in 2018 an...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Medical Association
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9012960/ https://www.ncbi.nlm.nih.gov/pubmed/35426926 http://dx.doi.org/10.1001/jamanetworkopen.2022.6692 |
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author | Delnevo, Cristine D. Jeong, Michelle Teotia, Arjun Bover Manderski, Michelle M. Singh, Binu Hrywna, Mary Wackowski, Olivia A. Steinberg, Michael B. |
author_facet | Delnevo, Cristine D. Jeong, Michelle Teotia, Arjun Bover Manderski, Michelle M. Singh, Binu Hrywna, Mary Wackowski, Olivia A. Steinberg, Michael B. |
author_sort | Delnevo, Cristine D. |
collection | PubMed |
description | IMPORTANCE: Physicians play a primary role in patient smoking cessation, yet their communication regarding e-cigarettes is not well understood. OBJECTIVE: To assess physician-patient communication regarding e-cigarettes. DESIGN, SETTING, AND PARTICIPANTS: A national cross-sectional survey in 2018 and 2019 was conducted. Participants were invited by mail; surveys were completed online. Respondents were 2058 board-certified physicians from family medicine, internal medicine, obstetrics and gynecology, cardiology, pulmonary, and oncology. Data were analyzed from August to September 2021. EXPOSURES: Physician demographic characteristics, tobacco use, medical specialty, and harm-reduction beliefs (ie, not all tobacco products are equally harmful) applied within 2 hypothetical clinical scenarios. MAIN OUTCOMES AND MEASURES: Physicians’ self-reported e-cigarette communication (being asked about e-cigarettes by patients and recommending e-cigarettes to patients) and hypothetical e-cigarette communication in 2 clinical scenarios. RESULTS: Among 2058 physicians, the mean (SD) age was 51.6 (10.5) years, and 1173 (58.5%) were male. More than 60% of physicians believed all tobacco products to be equally harmful. Overall, 69.8% of physicians reported ever being asked about e-cigarettes by their patients (35.9% in the past 30 days), and 21.7% reported ever recommending e-cigarettes to a patient (9.8% in the past 30 days). Pulmonologists (adjusted odds ratio [aOR], 2.14, 95% CI, 1.10-4.16) and cardiologists (aOR, 2.04; 95% CI, 1.03-4.05), as well as physicians who implemented the US Public Health Service Clinical Practice Guidelines (aOR, 1.77; 95% CI, 1.12-2.80), had greater odds of recommending e-cigarettes to patients. Physicians who endorsed a harm-reduction perspective (aOR, 3.04, 95% CI, 2.15-4.31) and had ever smoked cigarettes (aOR, 1.98; 95% CI, 1.27-3.08) were significantly more likely to recommend e-cigarettes. Physicians who reported being asked about e-cigarettes had greater odds of recommending e-cigarettes (aOR, 16.60; 95% CI, 10.33-26.68). In clinical scenarios, physicians were overall more likely to recommend e-cigarettes for cessation to an older heavy smoker with multiple unsuccessful quit attempts (49.3%; 95% CI, 47.1%-51.4%) than a younger light smoker with no prior cessation treatments (15.2%; 95% CI, 13.6%-16.7%) (P < .001). CONCLUSIONS AND RELEVANCE: In this survey study of physicians, findings suggest that physicians may recommend switching to e-cigarettes for some patients who smoke cigarettes under certain circumstances, presumably for cessation. The belief that all tobacco products are equally harmful was associated with lower rates of recommending e-cigarettes. As the evidence base grows for e-cigarette efficacy for smoking cessation, there is need for physician education regarding e-cigarette efficacy. |
format | Online Article Text |
id | pubmed-9012960 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-90129602022-05-02 Communication Between US Physicians and Patients Regarding Electronic Cigarette Use Delnevo, Cristine D. Jeong, Michelle Teotia, Arjun Bover Manderski, Michelle M. Singh, Binu Hrywna, Mary Wackowski, Olivia A. Steinberg, Michael B. JAMA Netw Open Original Investigation IMPORTANCE: Physicians play a primary role in patient smoking cessation, yet their communication regarding e-cigarettes is not well understood. OBJECTIVE: To assess physician-patient communication regarding e-cigarettes. DESIGN, SETTING, AND PARTICIPANTS: A national cross-sectional survey in 2018 and 2019 was conducted. Participants were invited by mail; surveys were completed online. Respondents were 2058 board-certified physicians from family medicine, internal medicine, obstetrics and gynecology, cardiology, pulmonary, and oncology. Data were analyzed from August to September 2021. EXPOSURES: Physician demographic characteristics, tobacco use, medical specialty, and harm-reduction beliefs (ie, not all tobacco products are equally harmful) applied within 2 hypothetical clinical scenarios. MAIN OUTCOMES AND MEASURES: Physicians’ self-reported e-cigarette communication (being asked about e-cigarettes by patients and recommending e-cigarettes to patients) and hypothetical e-cigarette communication in 2 clinical scenarios. RESULTS: Among 2058 physicians, the mean (SD) age was 51.6 (10.5) years, and 1173 (58.5%) were male. More than 60% of physicians believed all tobacco products to be equally harmful. Overall, 69.8% of physicians reported ever being asked about e-cigarettes by their patients (35.9% in the past 30 days), and 21.7% reported ever recommending e-cigarettes to a patient (9.8% in the past 30 days). Pulmonologists (adjusted odds ratio [aOR], 2.14, 95% CI, 1.10-4.16) and cardiologists (aOR, 2.04; 95% CI, 1.03-4.05), as well as physicians who implemented the US Public Health Service Clinical Practice Guidelines (aOR, 1.77; 95% CI, 1.12-2.80), had greater odds of recommending e-cigarettes to patients. Physicians who endorsed a harm-reduction perspective (aOR, 3.04, 95% CI, 2.15-4.31) and had ever smoked cigarettes (aOR, 1.98; 95% CI, 1.27-3.08) were significantly more likely to recommend e-cigarettes. Physicians who reported being asked about e-cigarettes had greater odds of recommending e-cigarettes (aOR, 16.60; 95% CI, 10.33-26.68). In clinical scenarios, physicians were overall more likely to recommend e-cigarettes for cessation to an older heavy smoker with multiple unsuccessful quit attempts (49.3%; 95% CI, 47.1%-51.4%) than a younger light smoker with no prior cessation treatments (15.2%; 95% CI, 13.6%-16.7%) (P < .001). CONCLUSIONS AND RELEVANCE: In this survey study of physicians, findings suggest that physicians may recommend switching to e-cigarettes for some patients who smoke cigarettes under certain circumstances, presumably for cessation. The belief that all tobacco products are equally harmful was associated with lower rates of recommending e-cigarettes. As the evidence base grows for e-cigarette efficacy for smoking cessation, there is need for physician education regarding e-cigarette efficacy. American Medical Association 2022-04-15 /pmc/articles/PMC9012960/ /pubmed/35426926 http://dx.doi.org/10.1001/jamanetworkopen.2022.6692 Text en Copyright 2022 Delnevo CD et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License. |
spellingShingle | Original Investigation Delnevo, Cristine D. Jeong, Michelle Teotia, Arjun Bover Manderski, Michelle M. Singh, Binu Hrywna, Mary Wackowski, Olivia A. Steinberg, Michael B. Communication Between US Physicians and Patients Regarding Electronic Cigarette Use |
title | Communication Between US Physicians and Patients Regarding Electronic Cigarette Use |
title_full | Communication Between US Physicians and Patients Regarding Electronic Cigarette Use |
title_fullStr | Communication Between US Physicians and Patients Regarding Electronic Cigarette Use |
title_full_unstemmed | Communication Between US Physicians and Patients Regarding Electronic Cigarette Use |
title_short | Communication Between US Physicians and Patients Regarding Electronic Cigarette Use |
title_sort | communication between us physicians and patients regarding electronic cigarette use |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9012960/ https://www.ncbi.nlm.nih.gov/pubmed/35426926 http://dx.doi.org/10.1001/jamanetworkopen.2022.6692 |
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