Most Doctors Confused About Risk Continuum

More than 60 percent of all U.S. doctors incorrectly believe all tobacco products are equally harmful, making them less likely to recommend e-cigarettes for people trying to quit smoking, according to a study led by Rutgers University and published in JAMA Network Open.

Researchers asked more than 2,000 doctors in the U.S. in 2018 and 2019 about how they would advise patients on using e-cigarettes as a method of combustible smoking cessation. One in four physicians discouraged all use of e-cigarettes and were also more likely to advise against them if the hypothetical smoker they were counseling were a younger, light smoker compared to an older, heavy smoker.

“These findings show it is critical to address physicians’ misperceptions and educate them on e-cigarettes’ efficacy, particularly correcting their misperceptions that all tobacco products are equally harmful as opposed to the fact that combusted tobacco is by far the most dangerous,” said lead author Cristine Delnevo, the director of the Rutgers Center for Tobacco Studies.

The belief that all tobacco products are equally harmful was associated with lower rates of recommending e-cigarettes, the study found, demonstrating the need for physician education.

“As the evidence base grows for e-cigarette efficacy for smoking cessation, physicians’ understanding of e-cigarettes in the context of harm reduction must keep pace with the emerging scientific evidence through effective educational opportunities,” the study’s authors wrote. “Such opportunities should address e-cigarette safety and efficacy and correct misperceptions that all tobacco products are equally harmful.”