Feasibility of a primary care patient decision aid for smoking cessation with information about e-cigarettes

Jennifer H LeLaurin; James F Thrasher; Scott M Strayer; John Malaty; Christy Kollath-Cattano; Maribeth Williams; Oliver T Nguyen; Allie M Kellner; James M Smith; Ramzi G Salloum

doi:10.1016/j.pmedr.2022.101745

Feasibility of a primary care patient decision aid for smoking cessation with information about e-cigarettes

Prev Med Rep. 2022 Mar 1:26:101745. doi: 10.1016/j.pmedr.2022.101745. eCollection 2022 Apr.

Affiliations

¹ Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.
² Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
³ Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
⁴ Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
⁵ Department of Health and Human Performance, College of Charleston, Charleston, SC, USA.
⁶ Division of General Internal Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.

Abstract

Decision aids can promote shared decision making and behavior change and may be effective in helping patients quit smoking. Patients are increasingly using e-cigarettes for smoking cessation; however, little is known about the impact of including e-cigarette information in smoking cessation decision aids. Our objective was to assess the feasibility and acceptability of a smoking cessation decision aid including e-cigarette information. This study was conducted at one family medicine clinic in the United States. We used a pre-post design. In Phase I, the decision aid presented information about approved cessation methods. In Phase II, current e-cigarette users and patients with no intention of quitting received additional information on switching to e-cigarettes. We assessed the impact of the decision aids on quit attempts and abstinence, confidence and readiness to quit, confidence and readiness to switch to e-cigarettes, and patient satisfaction. We enrolled 60 patients in each phase (N = 120). Patients reported higher confidence and readiness to quit after viewing the decision aids and consulting with their physician (p < 0.01). Patients reported the decision aid helped prepare them to make a decision about quitting smoking and expressed satisfaction with the decision aid and clinician consultation. We did not observe an impact of including e-cigarette information. Smoking cessation decision aids are acceptable to patients and may promote behavior change. Future studies should explore the impact of providing patients e-cigarette information using larger sample sizes and rigorous designs. Further research is needed to identify strategies to promote shared decision-making regarding e-cigarettes.

Keywords: Decision aids; E-cigarettes; FDA, U.S. Food & Drug Administration; HTP, Heated tobacco products; NRT, Nicotine replacement therapy; Shared decision-making; Vaping.