Healthcare professionals uncertain about promoting e-cigarettes to patients with cancer who smoke, study finds

Nearly 30% of healthcare professionals would not recommend e-cigarettes to patients with cancer who smoke, a study presented at the National Cancer Research Institute (NCRI) Cancer Conference 2018 has found^[1]
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The national study used an online survey to investigate UK healthcare professionals’ knowledge, attitudes and current practice of promoting e-cigarettes as a smoking cessation intervention in patients with cancer. The healthcare professionals included GPs, oncologists, cancer surgeons, practice nurses and cancer nurse specialists.

The researchers discovered that 29% of the 506 healthcare professionals surveyed would not recommend e-cigarettes to patients with cancer who smoke. Cancer surgeons and cancer nurse specialists were significantly less likely to recommend e-cigarettes than the other healthcare professionals. 

Over half of the healthcare professionals said they thought their knowledge was not sufficient to recommend e-cigarettes to patients with cancer and a quarter did not know whether e-cigarettes were less harmful than smoking tobacco cigarettes.

Furthermore, 46% said that their organisation did not have guidance on e-cigarettes and 45% said they were not sure.

The researchers concluded that training of healthcare professionals and local adoption of e-cigarette advice was needed to remove uncertainty around the promotion of e-cigarettes as a smoking cessation aid.

“These results suggest that there’s a lack of clear policy on e-cigarettes at the local level,” said Jo Brett, senior research fellow at Oxford Brookes University, who presented the study at the 2018 NCRI Cancer Conference in Glasgow on 6 November 2018.

“They also suggest a lack of awareness of existing evidence and national policy on e-cigarettes among doctors and nurses. This is coupled with a lack of time and inadequate training on smoking cessation in general, and specifically on e-cigarettes.

“Giving patients a clear message that they can reduce harm by switching from smoking to using e-cigarettes may help them cut down or quit smoking tobacco. This could help patients by reducing the risk of cancer recurrence, a second primary cancer or other complications.”

In April 2018, the National Institute for Health and Care Excellence and Public Health England published updated guidelines on stop smoking interventions and services. While they acknowledge that many people have found e-cigarettes helpful when quitting tobacco, the guidelines recommended that health and social care workers explain that evidence for their use is still developing, including research on their long-term health impact.