Abstract
ObjectivesDespite a sharp increase in e-cigarette use, there is debate about whether e-cigarettes are a viable alternative for harm reduction, and the forms that regulation should take. Healthcare providers can be effective in offering guidance to patients and their families and shaping regulatory policy. We described lung cancer specialists’ attitudes toward e-cigarettes and its regulation.MethodsWe undertook a nationwide survey of pulmonologists, thoracic surgeons, medical and radiological oncologists who are members of Korean Association for Lung Cancer. Survey items included beliefs and attitudes toward e-cigarettes, attitudes toward e-cigarette regulation and preparedness on discussing e-cigarettes with their patients.ResultsMost respondents believed that e-cigarettes are not safer than conventional tobacco cigarettes (75.7%) or smokeless tobacco (83.2%), and feared that discussing e-cigarettes with the patients would encourage use (65.4%). They did not consider it a smoking cessation treatment (78.3%), and thus would not recommend it to smokers who do not want to quit (82.2%) or who failed to quit with conventional smoking cessation treatment (74.1%). Most respondents supported all examples of e-cigarette regulations, including the safety and quality check (97.8%), warning label (97.8%), advertisement ban (95.1%), restriction of flavoring (78.4%), minimum purchasing age (99.5%), and restriction of indoor use (94.6%). Most learned about e-cigarettes from media and advertisements, or conversation with patients rather than through professional scientific resources, and reported discomfort when discussing e-cigarette with patients.ConclusionLung cancer specialist physicians in Korea doubt the safety of e-cigarette and use of e-cigarette as smoking cessation treatment, and supported strict regulation. However, only 20% reported that they obtained information on e-cigarettes from the scientific literature and many lacked adequate knowledge based on scientific evidence, suggesting the need for better preparedness. Nevertheless, the views of professionals revealed from our study could help to develop clinical guidelines and regulatory guidance.
Highlights
With stronger tobacco control, such as clean indoor air laws and cigarette tax increase, public interest in e-cigarettes has increased rapidly [1]
Lung cancer specialist physicians in Korea doubt the safety of e-cigarette and use of e-cigarette as smoking cessation treatment, and supported strict regulation
Most respondents disagreed that e-cigarettes are safer than conventional tobacco cigarettes (75.7%) or smokeless tobacco (83.2%), and they expressed considerable concern that e-cigarettes could be a gateway to other tobacco use (83.8%)
Summary
With stronger tobacco control, such as clean indoor air laws and cigarette tax increase, public interest in e-cigarettes has increased rapidly [1]. E-cigarette use has increased sharply in the US [2] and UK [3]. Dual use of e-cigarette with conventional tobacco cigarettes is increasingly common [5]. E-cigarettes are actively promoted through media channels, sports or music events, and outdoor or in-store displays [6]. They are usually portrayed as a safer alternative to conventional tobacco cigarettes or a smoking cessation aid [7], and perceived as such by smokers themselves. Smokers who ever used e-cigarettes reported less desire to quit smoking, reduction or cessation of conventional tobacco cigarettes, improved subjective health status, and recommended e-cigarettes to other smokers [8]
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