The popularity of electronic cigarettes is increasing, yet the research is lagging behind. In an effort to better understand, and therefore better advice our patients, a small number of current daily cigarette smokers were surveyed on their understanding of electronic cigarettes and their usage. Two smoking cessation counselors were also interviewed to better contextualize the role of electronic cigarettes as possible smoking cessation aids. Finally, a review of the available research was done to produce a poster, and possibly a handout, in hopes to educate all patients (regardless of their current smoking habits) regarding electronic cigarettes.https://scholarworks.uvm.edu/fmclerk/1120/thumbnail.jp

Velez, Alejandro

UVM ScholarWorks

University of VermontScholarWorks @ UVMFamily Medicine Clerkship Student Projects College of Medicine2015Community Perception of Electronic Cigarettesand Their Role as Smoking Cessation AidsAlejandro VelezUniversity of VemontFollow this and additional works at: http://scholarworks.uvm.edu/fmclerkPart of the Community Health Commons, Community Health and Preventive MedicineCommons, Medical Education Commons, Primary Care Commons, Public Health Education andPromotion Commons, and the Substance Abuse and Addiction CommonsThis Book is brought to you for free and open access by the College of Medicine at ScholarWorks @ UVM. It has been accepted for inclusion in FamilyMedicine Clerkship Student Projects by an authorized administrator of ScholarWorks @ UVM. For more information, please contactdonna.omalley@uvm.edu.Recommended CitationVelez, Alejandro, "Community Perception of Electronic Cigarettes and Their Role as Smoking Cessation Aids" (2015). Family MedicineClerkship Student Projects. Book 98.http://scholarworks.uvm.edu/fmclerk/98Alejandro VelezSeptember 2015Mentor: Dr. Jessica RouseCommunity Perception of Electronic Cigarettes and Their Role as Smoking Cessation AidsAddison Family Practice, Middlebury, VT2: Problem Identification and Description of Need• The prevalence of smokers in VT was highest among ages 25 to 44 at 22.9%• Around 22% of all high school students smoke on a regular basis  (2004 statistics)• The majority of smokers (60.4%) had at most a 12th grade education• The average of every day smokers that quit for at least one day in VT is less than the national average (49.6% vs. 52.2%)3: Public Health Cost• The tobacco industry spent $9.17 billion on marketing of cigarettes in 2012; 16.9 million in VT alone• $170 billion were spent on providing medical care in smoking related illnesses• Loss of productivity due to premature death and exposure to secondhand smoke totals nearly $150 billion each year• Smoking costs the United States billions of dollars each year.• State spending on tobacco prevention and control does not meet CDC-recommended levels.Current VT cigarette tax: $2.62 per pack (7th in the nation) Smoking-caused health care costs in Vermont: $10.04 per packAnnual health care expenditures in Vermont directly caused by tobacco use: $233 million Smoking-caused state Medicaid program spending each year: $72 million4: Community Perspective on Electronic Cigarettes and Smoking Cessation[Name Withheld] 802Quits Coach• “We do not recommend electronic cigarettes to the people we coach as there is limited research and they are not yet FDA approved”• The use of electronic cigarettes and regular cigarettes are “concurrently used…most often not as a smoking cessation aid”• 802Quits does not believe that electronic cigarettes are a good smoking cessation aid due to the lack of FDA approval Ed Lieberman, Behavioral Health Specialist and Smoking Cessation Counselor – Little City Family Practice• The most popular smoking cessation aids/therapies: Wellbutrin, Chantix, Nicotine patches, CBT and Mindfulness training• Around 5-10% of patients counseled by Ed have used e-cigs to attempt to quit• “A small percentage [of patients that I counsel believe e-cigs are healthier/safer than cigarettes]; or they come in with many questions about efficacy”• “[E-cigs are] Not my favorite approach, would like them to have all NRT (nicotine replacement therapy) option first…if they are very motivated to use them, I’ll work with that”• Ed believes that e-cigs could be used as a smoking cessation aid: “if it is used in context of a comprehensive plan in which it is a step towards abstinence”5: Intervention and MethodologyHi, my name is Alejandro Velez and I am a third year medical student at the University of Vermont. I am carrying out this survey, as part of my family medicine clerkship rotation, on all willing patients that self-report continued cigarette use during an office visit. This survey is part of a larger project on the use of electronic cigarettes in hopes to better understand the attitudes towards this growing market. No personal information will be attached to the answers of this survey but the final, compiled, results will be publically viewable. You have ABSOLUTELY NO OBLIGATION to fill out this survey. Filling out this survey will not affect your medical services at this practice. Thank you for considering taking this survey,Alejandro -------------------------------------------------------------------------------------------------------------------------------------1. Have you heard about electronic cigarettes?Yes or No (Choose ONE)---------------------------STOP! Did you answer “No” above? If so, YOURE DONE! Thank you…---------------------2. Do you use electronic cigarettes? Yes or No (Choose ONE)a. If Yes, How often? ______ (Indicate NUMBER of days per week)3. How likely are you try them/continue to use them? Very likely Likely Neutral Not likely Very unlikely (Choose ONE)4. Do you intend on attempting quitting in the next year? Yes or No (Choose ONE)a. If yes, do you believe electronic cigarettes can help you quit smoking? Yes or No (Choose ONE)5. Do you believe electronic cigarettes are healthier than regular cigarettes? Yes or No (Choose ONE)• Patients that self-reported smoking on a daily basis during an office visit were approached following the completion of the visit and asked to participate in a survey about electronic cigarettes• The patient fills out survey and drops it off at the front desk or with a nurse• Whether they agreed to take the survey or not, the patients were offered the electronic cigarette info-flyer6: Survey Results• Every current daily cigarette smoker reported hearing about electronic cigarettes • One quarter of current daily cigarettes smokers reported using or having used electronic cigarettes at one point• All of those that reported using electronic cigarettes in the past claimed that they were unlikely to continue to use them• Those that used electronic cigarettes in the past stopped using them after an average of 6 months• Around half of current daily cigarette smokers that reported not using electronic cigarettes said they were likely to try electronic cigarettes• Of those that intend to quit smoking regular cigarettes in the next year, around 40% believed that electronic cigarettes can help them quit• Around ¼ of current daily cigarette smokers believed that electronic cigarettes were healthier than regular ones7: Evaluation of Effectiveness and LimitationsInformation poster:• The information will be outdated as more studies are published• Informational flyer was only given to survey participants. A greater impact can be made with in-room posters and handouts for patients to take• The information was welcomed and posed in an objective mannerSurvey:• The number of people surveyed was too low to make major conclusions or statistical calculations• Not anonymous which could add a confounding factor• Extending the survey to other community practice in the area would give us better sampling of the local population8: Recommendations for Future Projects• Increase the number of people surveyed to get a better sense of the public’s perception on electronic cigarettes• Make the survey completely private/anonymous• Distribute survey to all patients regardless of stated smoking habits• Include a question on current/previous use of smoking cessation aids• Include a question to identify sources of information that patients use regarding electronic cigarettes• Acquire and distribute smoking cessation aid materials to all patients that take the survey including information about electronic cigarettes9: References• U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2015 Apr 7].• Federal Trade Commission. Federal Trade Commission Cigarette Report for 2012[PDF–308 KB]. Washington: Federal Trade Commission, 2015 [accessed 2015 Apr 7].• Xu X, Bishop EE, Kennedy SM, Simpson SA, Pechacek TF. Annual Healthcare Spending Attributable to Cigarette Smoking: An Update[PDF–157 KB]. American Journal of Preventive Medicine 2014;48(3):326–33 [accessed 2015 Apr 7].• Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs–2014. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2015 Apr 7].• Campaign for Tobacco Free Kids. Broken Promises to Our Children: The 1998 State Tobacco Settlement 16 Years Later[PDF–3.53 MB]. Washington: Campaign for Tobacco Free Kids, 2013 [accessed 2015 Apr 7].• Center for Disease Control and Prevention (2015). State Tobacco Activities Tracking and Evaluation (STATE) System [Data File]. Retrieved from: http://nccd.cdc.gov/STATESystem/rdDownload/rdExport-0aad41fd-dccc-45fd-ac95-2971e0b491a5/rdDLtwjemw400gelnoboxeu51ukx-76ad153060424d57ac41d579bfd3a09e.pdf• CDC, “Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs—United States 2000-2004,” MMWR 57(45):1226-1228, November 14, 2008, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5745a3.htm. 26 Miller, LS, et al., “State estimates of Medicaid expenditures attributable to cigarette smoking, fiscal year 1993,” Public Health Reports113(2):140-51, 1998.

Community Perception of Electronic Cigarettes and Their Role as Smoking Cessation Aids

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Community Perception of Electronic Cigarettes and Their Role as Smoking Cessation Aids

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