RESEARCH PAPER
E-cigarettes: online survey of UK smoking cessation practitioners
Rosemary Hiscock 1, 2
,  
Andy McEwen 2, 4, 5  
,  
Susan Murray 6
,  
 
 
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1
Department for Health, University of Bath, Bath, UK
2
UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
3
Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, USA
4
National Centre for Smoking Cessation and Training (NCSCT), London, UK
5
Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
6
School of Applied Social Science, University of Stirling, Stirling, UK
7
Action on Smoking and Health, London, UK
8
Public Health England, London, UK
9
Institute for Social Marketing, University of Stirling, Stirling, UK
CORRESPONDING AUTHOR
Andy McEwen   

UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
Publish date: 2014-08-21
 
Tobacco Induced Diseases 2014;12(August):13
KEYWORDS
ABSTRACT
Background:
Use of e-cigarettes (inhalable vapour producing battery powered devices that aim to simulate tobacco cigarettes), is rising in a number of countries, but as yet none of these products are regulated as medicinal devices or available as smoking cessation treatments. Smokers seeking support from health professionals to stop smoking are interested in e-cigarettes and may be buying them to aid a quit attempt. Determining what smokers are asking, and what health professionals think about these products may have implications for smoking treatment services in a number of countries.

Methods:
Stop smoking service advisors, managers and commissioners in the United Kingdom were asked to take part in two surveys on e-cigarettes. Data was analysed from 587 practitioners who completed a survey in 2011 and 705 practitioners who completed a repeat survey in 2013. Responses to multiple choice questions and free text comments were analysed.

Results:
Responding practitioners reported that interest in, and use of, e-cigarettes is growing among adults seeking help to stop smoking in the UK. In 2013 91% of respondents reported that interest in e-cigarettes had grown in the past year and whilst in 2011, 2% of respondents reported a ‘quarter to a half’ of their clients saying that they were regularly using e-cigarettes, by 2013 this had increased to 23.5% (p < .001). Responding practitioners’ views towards e-cigarettes became more positive between the first and second surveys (15% strongly agreed/agreed in 2011 that ‘e-cigarettes are a good thing’ rising to 26% in 2013). However, they continued to have concerns about the products. In particular, analysis of free text responses suggested practitioners were unsure about safety or efficacy for smoking cessation, and were worried that smokers may become dependent on the products. Practitioners were also aware of the potential of e-cigarettes to undermine smokers’ willingness to use evidence-based methods to stop, and to challenge policies aiming to denormalise tobacco smoking.

Conclusions:
Health professionals are asking for reliable and accurate information on e-cigarettes to convey to smokers who want to quit. Randomized controlled trials and ongoing surveillance of e-cigarette use and its consequences for smoking cessation rates and smoking treatment services are required.

 
REFERENCES (42)
1.
Adkison SE, O’Connor RJ, Bansal-Travers M, Hyland A, Borland R, Yong H-H, Cummings KM, McNeill A, Thrasher JF, Hammond D, Fong GT: Electronic nicotine delivery systems: international tobacco control four-country survey. Am J Prev Med. 2013, 44: 207-215.
 
2.
Dockrell M, Morison R, Bauld L, McNeill A: E-cigarettes: prevalence and attitudes in Great Britain. Nicotine Tob Res. 2013, 15: 1737-1744.
 
3.
ASH: Electronic cigarettes. Briefing. 2014,http://www.ash.org.uk/files/do....
 
4.
Etter JF, Bullen C, Flouris AD, Laugesen M, Eissenberg T: Electronic nicotine delivery systems: a research agenda. Tob Control. 2011, 20: 243-248.
 
5.
Flouris AD, Oikonomou DN: Electronic cigarettes: miracle or menace?. BMJ. 2010, 340: c311.
 
6.
Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, Walker N: Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet. 2013, 382: 1629-1637.
 
7.
Etter JF, Bullen C: Saliva cotinine levels in users of electronic cigarettes. Eur Respir J. 2011, 38: 1219-1220.
 
8.
Goniewicz ML, Kuma T, Gawron M, Knysak J, Kosmider L: Nicotine levels in e-cigarettes. Nicotine Tob Res. 2012, [Epub ahead of print].
 
9.
Bullen C, McRobbie H, Thorney S, Glover M, Lin R, Laugesen M: Effect of an electronic nicotine delivery device (e-cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomized cross-over trial. Tob Control. 2010, 19: 98-103.
 
10.
Eissenberg T: Electronic nicotine delivery devices: ineffective nicotine delivery and craving suppression after acute administration. Tob Control. 2010, 19: 87-88.
 
11.
Vansickel A, Cobb C, Weaver MF, Eissenberg TE: A clinical laboratory model for evaluating the acute effects of electronic “cigarettes”: nicotine delivery profile and cardiovascular and subjective effects. Cancer Epidemiol Biomarkers Prev. 2010, 19: 1945-1953.
 
12.
Etter JF: Electronic cigarettes: a survey of users. BMC Public Health. 2010, 10: 231.
 
13.
Etter JF, Bullen C: Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction. 2011, 106: 2017-2028.
 
14.
Siegel MB, Tanwar KL, Wood KS: Electronic cigarettes as a smoking cessation tool. Am J Prev Med. 2011, 40: 472-475.
 
15.
Goniewicz ML, Lingas EO, Hajek P: Patterns of electronic cigarette use and user beliefs about their safety and benefits: an Internet survey. Drug Alcohol Rev. 2013, 32: 133-140.
 
16.
Beard E, Brose LS, Brown J, West R, McEwen A: How are the English stop smoking services responding to growth in use of electronic cigarettes. Patient Educ Couns. 2013, Epub ahead of print.
 
17.
Gornall J: Electronic cigarettes: medical device or consumer product?. BMJ. 2012, 345: e6417.
 
18.
Cressey D: Regulation stacks up for e-cigarettes. Nature. 2013, 501: 473.
 
19.
Benowitz NMG: The regulatory challenge of electronic cigarettes. JAMA. 2013, 310: 685-686.
 
20.
Torjesen I: E-cigarettes are to be regulated as medicines from 2016. BMJ. 2013, 346: f3859.
 
21.
Memo: Questions & Answers: New rules for tobacco products.http://europa.eu/rapid/press-r....
 
22.
STS120720 monthly tracking of key performance indicators.http://www.smokinginengland.in....
 
23.
Statistics on NHS Stop Smoking Services, England - April 2012 to March 2013.http://www.hscic.gov.uk/search....
 
24.
Piné-Abata H, McNeill A, Murray R, Bitton A, Rigotti N, Raw M: A survey of tobacco dependence treatment services in 121 countries. Addiction. 2013, 108: 1476-1484.
 
25.
West R, Evans A, Michie S: Behaviour change techniques used in group-based behavioural support by the English stop-smoking services and preliminary assessment of association with short-term quit outcomes. Nicotine Tob Res. 2010, 12: 742-747.
 
26.
West R: Briefing 8: Stop smoking services: increased chances of quitting. NCSCT. 2012,http://www.ncsct.co.uk/usr/pub....
 
27.
BOS Bristol Online Surveys.http://www.survey.bris.ac.uk/.
 
28.
StataCorp: Stata Statistical Software: Release11. 2010, College Station: Stata-Corp LP.
 
29.
Caponnetto P, Campagna D, Cibella F, Morjaria JB, Caruso M, Russo C, Polosa R: Efficiency and safety of an electronic cigarette (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study. PLoS One. 2013, 8: e66317.
 
30.
Andrade M, Hastings G, Angus K: Promotion of electronic cigarettes: tobacco marketing reinvented?. BMJ. 2013, 347: f7473.
 
31.
Hsu R, Myers AE, Ribisl KM, Marteau TM: An observational study of retail availability and in-store marketing of e-cigarettes in London: potential to undermine recent tobacco control gains?. BMJ Open. 2013, 3: e004085.
 
32.
Faletau J, Glover M, Nosa V, Pienaar F: Looks like smoking, is it smoking?: children’s perceptions of cigarette-like nicotine delivery systems, smoking and cessation. Harm Reduct J. 2013, 10: 30.
 
33.
Camenga DR, Delmerico J, Kong G, Cavallo D, Hyland A, Cummings KM, Krishnan-Sarin S: Trends in use of electronic nicotine delivery systems by adolescents. Addict Behav. 2014, 39: 338-340.
 
34.
Sutfin EL, McCoy TP, Morrell HER, Hoeppner BB, Wolfson M: Electronic cigarette use by college students. Drug Alcohol Depend. 2013, 131: 214-221.
 
35.
E-Cigarettes To Be Stubbed Out For Under 18s.http://www.bbc.co.uk/news/uk-2....
 
36.
Etter J-F, Bullen C: A longitudinal study of electronic cigarette users. Addict Behav. 2014, 39: 491-494.
 
37.
Etter J-F: Levels of saliva cotinine in electronic cigarette users. Addiction. 2014, Epub ahead of print.
 
38.
Fagerström KO, Bridgman K: Tobacco harm reduction: the need for new products that can compete with cigarettes. Addict Behav. 2014, 39: 507-511.
 
39.
Schripp T, Markewitz D, Uhde E, Salthammer T: Does e-cigarette consumption cause passive vaping?. Indoor Air. 2013, 23: 25-31.
 
40.
Czogala J, Goniewicz M, Fidelus B, Zielinska-Danch W, Travers M, Sobczak A: Secondhand exposure to vapors from electronic cigarettes. Nicotine Tob Res. 2013, Epub ahead of print.
 
41.
Kasza K, Bansal-Travers M, O’Connor R, Compton W, Kettermann A, Borek N, Fong G, Cummings K, Hyland A: Cigarette smokers’ use of unconventional tobacco products and associations with quitting activity: findings from the ITC-4, U.S. Cohort. Nicotine Tob Res. 2013, Epub ahead of print.
 
42.
Choi K, Forster JL: Beliefs and experimentation with electronic cigarettes: a prospective analysis among young adults. Am J Prev Med. 2014, 46: 175-178.
 
 
CITATIONS (20):
1.
Experimentation and correlates of electronic nicotine delivery system (electronic cigarettes) among university students – A cross sectional study
K.H. Awan
The Saudi Dental Journal
 
2.
Overview of Electronic Nicotine Delivery Systems: A Systematic Review
Allison M. Glasser, Lauren Collins, Jennifer L. Pearson, Haneen Abudayyeh, Raymond S. Niaura, David B. Abrams, Andrea C. Villanti
American Journal of Preventive Medicine
 
3.
Chemical characterisation of aerosols emitted by electronic cigarettes using thermal desorption–gas chromatography–time of flight mass spectrometry
Christopher Rawlinson, Stuart Martin, Justin Frosina, Chris Wright
Journal of Chromatography A
 
4.
Electronic cigarette aerosol induces significantly less cytotoxicity than tobacco smoke
David Azzopardi, Kharishma Patel, Tomasz Jaunky, Simone Santopietro, Oscar M. Camacho, John McAughey, Marianna Gaça
Toxicology Mechanisms and Methods
 
5.
E-cigarettes as smoking cessation aids: a survey among practitioners in Italy
Lambros Lazuras, Milena Muzi, Caterina Grano, Fabio Lucidi
International Journal of Public Health
 
6.
The knowledge, concerns and healthcare practices among physicians regarding electronic cigarettes
Venkatkiran Kanchustambham, Swetha Saladi, Jonathan Rodrigues, Hermina Fernandes, Setu Patolia, Sadhashiv Santosh
Journal of Community Hospital Internal Medicine Perspectives
 
7.
Electronic cigarette use and risk perception in a Stop Smoking Service in England
Frances C. Sherratt, Michael W. Marcus, Jude Robinson, Lisa Newson, John K. Field
Addiction Research & Theory
 
8.
A typology of vaping: Identifying differing beliefs, motivations for use, identity and political interest amongst e-cigarette users
Hannah Farrimond
International Journal of Drug Policy
 
9.
Is it safe to use smoking cessation therapeutics during pregnancy?
Nicole E De Long, Nicole G Barra, Daniel B Hardy, Alison C Holloway
Expert Opinion on Drug Safety
 
10.
Electronic cigarettes: a survey of perceived patient use and attitudes among members of the British thoracic oncology group
Frances C. Sherratt, Lisa Newson, John K. Field
Respiratory Research
 
11.
Views from the Coalface: What Do English Stop Smoking Service Personnel Think about E-Cigarettes?
Rosemary Hiscock, Linda Bauld, Deborah Arnott, Martin Dockrell, Louise Ross, Andy McEwen
International Journal of Environmental Research and Public Health
 
12.
Perceptions towards electronic cigarettes for smoking cessation among Stop Smoking Service users
Frances C. Sherratt, Lisa Newson, Michael W. Marcus, John K. Field, Jude Robinson
British Journal of Health Psychology
 
13.
Knowledge and beliefs about electronic cigarettes among quitline cessation staff
Sharon Cummins, Scott Leischow, Linda Bailey, Terry Bush, Ken Wassum, Lesley Copeland, Shu-Hong Zhu
Addictive Behaviors
 
14.
Counseling patients with asthma and allergy about electronic cigarettes: an evidence-based approach
Riccardo Polosa, Davide Campagna, Mark F. Sands
Annals of Allergy, Asthma & Immunology
 
15.
Using e-cigarettes in the home to reduce smoking and secondhand smoke: disadvantaged parents' accounts
Neneh Rowa-Dewar, Catriona Rooke, Amanda Amos
Health Education Research
 
16.
Developing E-cigarette friendly smoking cessation services in England: staff perspectives
Hannah Farrimond, Charles Abraham
Harm Reduction Journal
 
17.
Smokers’ knowledge and perception of electronic cigarettes (e-cigarettes): a qualitative study of non-quitting smokers in a North London general practice
Vanessa Vasconcelos, Hazel Gilbert
Primary Health Care Research & Development
 
18.
GPs’ and nurses’ perceptions of electronic cigarettes in England: a qualitative interview study
Melissa Stepney, Paul Aveyard, Rachna Begh
British Journal of General Practice
 
19.
Therapeutic Radiographers' perceptions of the barriers and enablers to effective smoking cessation support
L. Charlesworth, D. Hutton, H. Hussain
Radiography
 
20.
Stop Smoking Practitioners’ understanding of e-cigarettes’ use and efficacy with particular reference to vapers’ socioeconomic status
Rosemary Hiscock, Deborah Arnott, Martin Dockrell, Louise Ross, Andy McEwen
Journal of Smoking Cessation
 
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