Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Br J Gen Pract. 2019 Jan;69(678):e8-e14. doi: 10.3399/bjgp18X699821. Epub 2018 Nov 5.
Reports from royal colleges and organisations such as Public Health England suggest that GPs and nurses should advise patients to switch to electronic cigarettes (e-cigarettes) if they do not want to stop smoking using licensed medication. However, there are no data on what practitioners think, feel, or do about e-cigarettes.
To explore practitioners' perceptions and attitudes towards e-cigarettes, and their experiences of discussing e-cigarettes with patients.
A qualitative interview study was carried out with semi-structured interviews conducted with nurses and GPs across England in 2017.
Participants were interviewed once either via telephone or face to face. Data were analysed using thematic analysis.
Interviews were conducted with 23 practitioners (eight nurses and 15 GPs). There were three key themes: ambivalence and uncertainty; pragmatism; and responsibility. Many practitioners had uncertainties about the safety and long-term risks of e-cigarettes. Some had ambivalence about their own knowledge and ability to advise on their use, as well as uncertainty about whether to and what to advise patients. Despite this, many sought to provide honesty in consultations by acknowledging these uncertainties about e-cigarettes with patients and taking a pragmatic approach, believing that e-cigarettes were a 'step in the right direction'. Practitioners wanted advice from healthcare regulators such as the National Institute for Health and Care Excellence to reassure them about the safety of e-cigarettes, practical tools to support the consultation, and to control their use by providing behavioural support programmes for reduction or cessation.
Current dissemination strategies for guidelines are not effective in reaching practitioners, who are offering more cautious advice about e-cigarettes than guidelines suggest is reasonable.
英国皇家学院和公共卫生英格兰等组织的报告表明，如果患者不想通过合法药物戒烟，全科医生和护士应建议患者改用电子烟。然而，目前尚无关于从业者对电子烟的看法、感受或做法的数据。
探讨从业者对电子烟的看法和态度，以及他们与患者讨论电子烟的经验。
2017 年，在英格兰进行了一项半结构式访谈的定性访谈研究，参与者为护士和全科医生。
参与者通过电话或面对面的方式接受了一次访谈。使用主题分析对数据进行分析。
共对 23 名从业者（8 名护士和 15 名全科医生）进行了访谈。有三个关键主题：矛盾和不确定性；实用主义；和责任。许多从业者对电子烟的安全性和长期风险存在不确定性。一些人对自己的知识和能力感到矛盾，不知道是否应该以及向患者提供何种建议。尽管如此，许多人还是希望在咨询中坦诚相待，向患者承认他们对电子烟的不确定性，并采取务实的方法，认为电子烟是“朝着正确方向迈出的一步”。从业者希望医疗保健监管机构（如国家卫生与保健卓越研究所）提供有关电子烟安全性的建议，提供实用的咨询工具，并通过提供行为支持计划来控制电子烟的使用，以帮助患者减少或戒除电子烟。
目前，指南的传播策略对从业者没有效果，他们对电子烟的建议比指南建议的更为谨慎。
