Beliefs, Attitudes, and Confidence to Deliver Electronic Cigarette Counseling among 1023 Chinese Physicians in 2018

Background: The use of electronic cigarettes (e-cigarettes) is gaining popularity, so it is important to evaluate physicians' understanding of e-cigarettes. This study assessed the beliefs, attitudes, and confidence in e-cigarette counseling among Chinese physicians and explored the factors related to asking patients about e-cigarette use. Methods: Physicians from across China were invited to participate in a questionnaire survey using the platform provided by DXY (www.dxy.cn) in 2018. In total, 1023 physicians completed the online survey. Descriptive analyses were used to characterize the participants, and multivariate logistic regression analyses were applied to identify predictors of physicians' asking about patients' e-cigarette use. Results: Only 46.3% of respondents agreed that e-cigarettes had adverse health effects, and 66.8% indicated that e-cigarettes can be regarded as a type of smoking cessation treatment. We found that 61.3% thought it was important to discuss e-cigarettes with patients, and 71.7% reported feeling confident about their ability in counseling about e-cigarettes. Respondents who had used e-cigarettes (OR = 2.05; 95% CI: 1.16-2.63), had received training about e-cigarettes (OR = 3.13; 95% CI: 2.17-4.52), or were confident about their ability to answer patients' question about e-cigarettes (OR = 2.45; 95% CI: 1.65-3.65) were more likely to ask patients about e-cigarette use. Physicians who showed a supportive attitude toward using e-cigarettes to quit smoking (OR = 0.79; 95% CI: 0.63-0.99) were less likely to ask about patients' e-cigarettes use frequently. Conclusions: Chinese physicians appeared to ignore the adverse health effects of e-cigarettes, and considered e-cigarettes as a smoking cessation treatment. Comprehensive training and regulations are needed to help physicians incorporate the screening of e-cigarette use into routine practice and provide patients truthful information as new data emerge.