General practitioners' knowledge, attitudes, beliefs and practices surrounding the prescription of e-cigarettes for smoking cessation: a mixed-methods systematic review

Melis Selamoglu; Bircan Erbas; Karthika Kasiviswanathan; Chris Barton

doi:10.1186/s12889-022-14696-3

General practitioners' knowledge, attitudes, beliefs and practices surrounding the prescription of e-cigarettes for smoking cessation: a mixed-methods systematic review

BMC Public Health. 2022 Dec 23;22(1):2415. doi: 10.1186/s12889-022-14696-3.

Authors

Melis Selamoglu^{1

2}, Bircan Erbas³, Karthika Kasiviswanathan⁴, Chris Barton⁵

Affiliations

¹ Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Melis.Selamoglu@monash.edu.
² , Level 5, 553 St Kilda Road, Prahan, VIC, 3181, Australia. Melis.Selamoglu@monash.edu.
³ Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
⁴ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
⁵ Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Abstract

Background: General practitioners (GPs) play an important role in providing patients who smoke with health information, support and treatment to encourage them to quit smoking. Despite conflicting evidence on the effectiveness of electronic cigarettes (e-cigarettes) as a smoking cessation aid, there is growing interest in the role e-cigarettes might play as an alternative to smoking tobacco. This systematic review aims to synthesise evidence from qualitative, quantitative and mixed-methods studies of the knowledge, attitudes, beliefs and social norms of GPs with respect to the use of e-cigarettes as smoking cessation aids.

Methods: This study adhered to the PRISMA guidelines. Studies from MEDLINE, CINAHL, SCOPUS, PsycINFO, EMBASE and grey literature were searched. Two independent reviewers screened abstracts and full-text articles to identify studies that met the inclusion criteria. A data extraction form was used to extract relevant data from included papers and were quality appraised using the MMAT checklist. A PRISMA flow diagram was used to record the flow of papers and reasons for exclusion. Studies were included if they collected quantitative, qualitative or mixed methods data to determine knowledge, attitudes, beliefs and social norms of GPs for use of e-cigarettes as smoking cessation aids.

Results: A total of 4056 abstracts were screened and 25 articles were included. Our findings showed that GPs had mixed views on recommending e-cigarettes as a smoking cessation aid. Some GPs were optimistic and had recommended e-cigarettes to their patients. Others were reluctant and disagreed that e-cigarettes are an effective method to quit smoking. Most GPs lacked knowledge and confidence in having discussions with patients around e-cigarette safety and efficacy as smoking cessation alternatives.

Conclusion: This systematic review shows there are mixed views on e-cigarettes as smoking cessation aids. Clear guidance on the role of e-cigarettes is needed to inform and upskill GPs about e-cigarettes for smoking cessation.

Prospero registration: CRD42021227612.

Keywords: attitudes; e-cigarette; general practice; knowledge; smoking cessation; systematic review.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Electronic Nicotine Delivery Systems*
General Practitioners*
Health Knowledge, Attitudes, Practice
Humans
Prescriptions
Smoking Cessation* / methods