Acceptability to general practitioners of e-cigarettes as a smoking cessation aid: systematic review

Problem

General Practitioners (GPs) play an important role in providing patients who smoke with health information, support and treatment to encourage them to quit smoking. Despite conflicting evidence on the effectiveness of e-cigarettes as a smoking cessation aid, many smokers and GPs are exploring e-cigarettes as an alternative to smoking tobacco, believing that e-cigarettes can reduce the harm associated with cigarettes and promote smoking cessation. This systematic review aims to synthesise evidence from qualitative, quantitative and mixed-methods studies of the perceptions of GPs towards e-cigarettes and their intentions to prescribe e-cigarettes as a smoking cessation aid.

Approach

Studies from four databases MEDLINE, CINAHL, SCOPUS and EMBASE were searched. Two independent reviewers screened abstracts and full-text studies that met the inclusion criteria. Papers were appraised for quality using the MMAT checklist. A data extraction form was used to extract relevant data from included papers. A PRISMA flow diagram was used to record the flow of papers through the review and the reasons for exclusion at each stage.

Findings

A total of 3939 abstracts were identified and their titles and abstracts were screened for relevance. Fifteen articles met the inclusion criteria and were included. Synthesis of findings is ongoing however, preliminary findings indicate GPs had mixed views on recommending e-cigarettes as a smoking cessation aid. Some GPs were positive about a role for e-cigarettes and had recommended e-cigarettes to their patients as part of a smoking cessation plan. Others were reluctant and disagreed that e-cigarettes are an effective method to quit smoking. Most GPs lacked knowledge and confidence in having discussions with patients around e-cigarette safety and efficacy as a smoking cessation aid.

Consequences

Clear guidance on the role of e-cigarettes is needed to inform and educate GPs about e-cigarettes as a smoking cessation aid. This information from this review will be useful to guide policy on e-cigarettes and contribute to guideline development that informs the potential role and place of e-cigarettes as a smoking cessation alternative.