Perceptions of Australian general practitioners on e-cigarettes as a smoking cessation aid

Problem

A significant policy change in Australia impacting the availability of nicotine for use in electronic cigarettes (e-cigarettes) took effect in late 2021. This change means that nicotine containing liquids for use with e-cigarettes will only be available by prescription from a health care provider. This is an opportunity for health care providers, and general practitioners (GPs) in particular, to discuss use of e-cigarettes and provide information and support for smoking cessation more broadly to patients who use, or are interested in using, these devices. Little is known about Australian GPs preparedness to have discussions with patients and their perceptions about prescription of e-cigarettes to support smoking cessation.The aims of this study are to determine GPs knowledge, attitudes, beliefs and confidence discussing e-cigarettes with patients for smoking cessation and intentions to prescribe e-cigarettes to quit smoking.

Approach

An online survey was distributed nationally through practice-based research networks, primary health networks and social media platforms. Selection of survey items was guided by the theory of planned behaviour and included questions assessing knowledge, attitudes, beliefs and prescribing intentions of e-cigarettes as a smoking cessation aid.

Findings

A preliminary analysis of the first 209 responses was conducted. Two thirds of respondents were female GPs (64%) and average age was 43 years. Most GPs worked in a group practice (70.6%) with an average of 12 years’ experience. Almost all GPs believed it is their responsibility to aid patients in getting the correct help to quit smoking (97.8%), but less than half agreed that e-cigarettes were a suitable smoking cessation aid (46.2%) or safer than regular cigarettes (42.8%). GP colleagues (54.9%) and online GP groups (50%) were likely to influence their decision to counsel, recommend and prescribe e-cigarettes. Australian GPs knowledge about e-cigarettes was poor and they were not confident in their ability to discuss e-cigarettes with patients or prescribe nicotine e-liquid. The vast majority (88.6%) have not recommended the use of e-cigarettes, 43.2% won’t be prescribing e-cigarettes and 40.2% do not recommend e-cigarettes for smoking cessation.

Consequences

Internationally there are mixed and contested views on the role of e-cigarettes to support smoking cessation. In Australia, nicotine containing e-liquids are only available by prescription from authorised prescribers. Our preliminary analysis of data suggests Australian GPs have limited knowledge about e-cigarettes, do not recommend e-cigarettes and lack confidence in discussing e-cigarettes as a smoking cessation aid with their patients. The results from this study will provide crucial insights to guide policy and guidelines for practice, particularly in regards to GPs work in supporting patients to quit smoking.