What Do Doctors Know About Vaping?

A new survey that covered over 15,000 doctors in eleven countries has discovered worryingly high levels of misunderstanding about nicotine and ignorance when it comes to vapes. The research was conducted by Sermo, a private social media network for doctors, which used funding from the Foundation for a Smokefree World to establish established a Global Advisory Board and a National Advisory Board for the Doctors’ Survey.

The Foundation for a Smokefree World explained: “The Global Advisory Board and a National Advisory Board helped develop the survey discussion guide and participated in the qualitative portion of the survey, providing insights on the findings.”

Doctors were interviewed in the United Kingdom and from China, Germany, Greece, India, Indonesia, Israel, Italy, Japan, South Africa, and the United States. In total, 15,335 of them took part in the online quantitative interviews.The clinicians were asked about various subjects including their opinions about nicotine and reduced-risk products such as vapes. They were also quizzed on how they encourage smoking patients to quit.

How the UK sample breaks down
1,191 doctors from the UK took part in the study, all of them being fully licenced and working full-time. Everyone had been practicing for over two years and spending at least half of their time in direct patient contact. The doctors were specialists in Family/General Practice, Internal Medicine, Cardiology, Pulmonology, Oncology, and Psychiatry – all areas requiring a thorough understanding of smoking, vaping and tobacco harm reduction. On average, they said they see 20 smokers a month.

Of the 1,191, 85.7% have never smoked themselves, 12.8% used to smoke but have stopped, while 1.6% are still current smokers. More than half of the smokers had tried to quit multiple times relying almost exclusively on trying to quit cold turkey – and this appears to play a big part in how they understand smoking cessation.

What surveyed doctors consider to be the best method of quitting smoking
Amazingly, 44% of doctors believe that just going cold turkey is the most effective method with just 9% currently believing that vaping is the most effective route.

Research has shown that ecigs work up to three times more effectively than traditional nicotine replacement products and this is why they are the country’s number one route away from tobacco addiction.

This finding is troubling as Sermo states that 77% of smokers want to quit and therefore need proper support and education.

The stop smoking training doctors receive
UK doctors revealed more troubling data on this topic as 17% said they have received no formal smoking cessation advice training and 45% said they were “self-trained”. Again, this finding goes towards explaining why so many hold misconceptions about nicotine and vaping.

On a positive note, 83% of the doctors said they were interested in receiving proper training on the subject.

But why haven’t they completed relevant training?

In a section where they could offer multiple answers, 31% said they were too busy, 19% said the training wouldn’t be recognised as a continuing education credit, 53% said they weren’t aware of any training opportunities, and 58% said they’d never been offered any training opportunity.

What action do doctors take with patients?
For those doctors who take a proactive stance in supporting patients to quit (multiple answers allowed):

·80% refer patients to stop smoking clinics
·55% prescribe medication
·38% tell smokers to seek the support of their family and friends
·35% recommend vaping with electronic cigarettes
·16% recommend alternative therapies such as hypnosis
·10% suggest using a stop smoking mobile phone app

What surveyed doctors get wrong
77% wrongly think that nicotine is the component in smoke that causes tobacco related illness and death. On a range of individual ailments, between 10 to 15% mistakenly blamed nicotine.

21% said they have never heard of the term ‘harm reduction’, 32% have never heard of ‘modified risk’, 46% don’t know what the official NHS guidelines are, and a massive 53% are completely unaware of government/regulatory guidelines.

What doctors want to see happen
Incredibly, over a third of those surveyed want vaping banned in public spaces. Worse, 69% don’t believe vapes should be taxed less than tobacco products – and 20% want to see vaping regulated in exactly the same way as smoking. In fact, 10% want to see vapes taxed more harshly than cigarettes and 7% want them banned completely.

This compares with 9% of forward thinkers who think tax-free vapes would be an ideal way of reducing smoking rates.

54% don’t believe that vapes should be widely available to adults who wish to reduce/quit smoking.

22% feel e-cigs “should be restricted as smoking cessation aids to use in certain patient types or clinical situations (e.g., patients who have failed to quit by other means)”, and 16% only want to see vapes sold through physicians or pharmacists.

The Foundation for a Smokefree World says
The Foundation said: “While on average 87% of doctors at least moderately agree that helping patients quit smoking is a priority, lack of training and nicotine knowledge adversely impacts quitting and harm reduction advice.

“These survey findings underscore the urgency for doctors to receive proper training about nicotine and tobacco harm reduction options to help their smoking patients quit smoking.”

What training is available?
Strikingly, free training and online resources are available to all practising medical professionals from The National Centre for Smoking Cessation and Training, “a social enterprise committed to support the delivery of smoking cessation interventions provided by local stop smoking services, support the NHS and Local Authorities to deliver effective evidence-based tobacco control programmes, and deliver training and assessment programmes to stop smoking practitioners and other health and social care professionals.”

The Centre draws inspiration from the eight Public Health England evidence updates and the ongoing evidence review being carried out by Cochrane. On releasing its latest review, Cochrane stated: “A Cochrane review has found the strongest evidence yet that e-cigarettes, also known as ‘vapes’, help people to quit smoking better than traditional nicotine replacement therapies, such as patches and chewing gums.”

It also identified: “We did not detect any clear evidence of harm from nicotine e-cigarettes when used to quit smoking.”

With the government, NHS, and professional bodies such as the Royal College of Physicians fully behind the use of vapes to quit smoking and the existence of The National Centre for Smoking Cessation and Training providing evidenced facts about nicotine and vaping, it’s imperative that more is done to help doctors improve their understanding and prevent the scourge of smoking related disease and death.