Pediatrician Knowledge, Attitudes, and Practice Related to Electronic Cigarettes

Abstract Purpose Electronic cigarettes (e-cigarettes) have grown rapidly in popularity, creating concerns for pediatricians and families. Evaluating pediatricians' understanding of e-cigarettes is an important first step in effectively addressing these products in practice. This qualitative study assesses pediatricians' knowledge, attitudes, and current clinical practices related to e-cigarettes. Methods We conducted six focus groups with 37 pediatric clinicians in 2014. Groups were led by a trained facilitator using a semistructured discussion guide. Responses were recorded, transcribed, and coded to identify relevant themes. Results Pediatricians know that e-cigarettes generally contain nicotine and that adolescents and young adults are most likely to use them. However, most feel uninformed about the health effects of e-cigarettes and report wanting scientific evidence for safety or harm from credible sources. Pediatricians are skeptical of claims that e-cigarettes are safe, either for users or for those exposed to second-hand e-cigarette vapor or emissions. Participants noted that clinical conversations about e-cigarettes were rare, citing barriers including a lack of systematic screening, competing priorities during clinical visits, and, for some, limited confidence in their ability to address e-cigarettes during clinical encounters. No participants recommended e-cigarettes for cessation. Conclusions Pediatricians feel poorly informed about e-cigarettes and are concerned about their potential health effects. While clinical discussions about e-cigarettes are rare, recent increases in their use leaves many clinicians wanting guidance about what to say to patients and families.