Many GPs and Nurses are still widely misinformed about vaping
Smoking is the UK’s leading cause of preventable illness and death, with treatment proving to be a huge cost to the NHS. It is therefore imperative that GPs and Nurses are suitably equipped to help smokers quit, but do medical professionals recommend e-cigarettes effectively?
Cancer Research UK has released an extensive piece of research into attitudes towards vaping, among GPs and nurses.
What is the current guidance for medical professionals?
Numerous pieces of guidance from the UK government and recognised health bodies encourage the endorsement of e-cigarettes as a smoking cessation aid.
The 2017 Tobacco Control Plan by Public Health England (PHE) included the following action:
‘PHE will provide evidence-based guidance for health professionals to support them in advising smokers who want to use e-cigarettes or other nicotine delivery systems to quit.’
In 2018, the National Institute for Health and Care Excellence (NICE) updated its guidelines, stating the following point:
‘The evidence suggests that e-cigarettes are substantially less harmful to health than smoking but are not risk free’.
Furthermore, the National Centre for Smoking cessation and training also released a briefing for Stop Smoking Services. The guidance is particularly supportive of vaping as a smoking cessation aid and states
‘Public Health England recommends that stop smoking services should offer support to people who are using e-cigarettes in a quit attempt.’
As well as these direct pieces of guidance, a plethora of research has been released to support the use of e-cigarettes to help people quit smoking. However, is this message getting through to GPs and nurses?
Do Medical Professionals recommend e-cigarettes?
In October, 2019 Cancer Research UK released a cross-sectional survey exploring the attitudes, belief advice and knowledge regarding e-cigarettes. A vast series of questions were posed to 2000 GPs and nurses. The survey was particularly extensive so we will highlight some of the key results.
The first notable statistic is that 35.9% of nurses and 25.7% of GPs are unsure if e-cigs are beneficial over smoking. This figure is particularly concerning considering the mass amount of positive research and the statement from Public Health England which estimates that vaping is 95% less harmful than smoking. With GPs and nurses being unsure about what should now be common knowledge, it’s understandable that a high proportion of smokers are also uninformed.
With guidance in place and public health bodies releasing so much positive research about vaping, why do medical professionals still have this fundamental misunderstanding? Well, the main source for GPs and nurses to find out information about e-cigarettes is news outlets. This was the answer for a worrying 58.3% of the 2000 GPs and nurses surveyed. A mere 17% cited professional associations as the main source of e-cigarette information.
The media is famed for releasing unreliable research regarding e-cigarettes so it’s no real surprise that many medical professionals are uninformed, if this is where they are obtaining their information.
Is more training needed to help medical professionals recommend e-cigarettes effectively?
The GPs and nurses surveyed certainly believe that more training would beneficial. In fact, 78.2% of nurses and 62.1% of GPs at least somewhat agreed that they would like more training. However, 42.7% at least somewhat agreed that they do not see e-cigarette training as a priority.
With smoking proving to be the leading preventable cause of disease and mortality, and e-cigarettes proving to be the most effective smoking cessation aid, is it not time to make it a priority? Many of the survey results simply showed a lack of knowledge, which could be rectified by simple training and more comprehensive guidance documents.
For example, 47% of nurses and 58.8% of GPs at least “somewhat” disagreed that people are better off using e-cigarettes than they would be using tobacco products. There is an incredible amount of strong evidence which shows people are far better off using e-cigarettes over cigarettes.
More than two thirds of nurses and GPs at least “somewhat” agreed that they “worry that e-cigarettes are luring young people into smoking”. Again, this theory has been dismissed by leading professors in the UK on numerous occasions.
45.2% of nurses and 33.3% of GPs advise that long-term e-cig use is harmful. Again, there is no evidence to back this up. While the long-term effects may not be fully known, to say it is harmful without evidence is arguably irresponsible.
Whilst the NHS may be strained, there is little excuse for this vast lack of knowledge from medical professionals. There is no scenario where it is better to smoke than vape but this message clearly in’t getting thorugh. Cancer Research UK understands this and recommended the following policy changes.
Earlier this year Cancer Research UK suggested that medical professionals should be given e-cigarette training. On the back of the results, the organisation has made further policy recommendations. These include:
‘Embed smoking cessation advice and interventions routinely in primary care practice.’
‘Improve communication and dissemination of consistent, evidence-based messages about e-cigarettes to primary healthcare professionals.’
‘Incorporate information on e-cigarettes in education and training programmes.’
Thank you to Cancer Research UK for providing such a comprehensive report. The results are concerning but not surprising considering the power that misleading media has on the industry. We hope to see the recommendations made being acted on and a forward-thinking attitude employed by professional medical associations.