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Health professionals reluctant to recommend e-cigarettes

The evidence for the use of e-cigarettes as a less harmful alternative to smoking is still developing, including research on their long-term health impact. (Photograph: Andrey_Popov/Shutterstock)

Fri. 23 November 2018

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GLASGOW, UK: According to research presented at the recent annual National Cancer Research Institute (NCRI) Cancer Conference in Glasgow, 29 per cent of health professionals would not recommend e-cigarettes to cancer patients who already smoke. In addition, more than half of those professionals surveyed said that they did not know enough about e-cigarettes to make recommendations to patients.

Dr Jo Brett, a senior research fellow in the Faculty of Health and Life Sciences at Oxford Brookes University in Oxford, led the research team in surveying 506 health professionals from across the UK, including 100 cancer surgeons and 99 oncology nurses. They were asked about their knowledge of e-cigarettes, whether they would recommend them to cancer patients who smoke, and what their hospital or practice policies were on the use of e-cigarettes.

Around a quarter of those surveyed stated that they did not know whether e-cigarettes were less harmful than smoking. Forty-six per cent said their hospital or clinic did not have guidance on what advice they should give to patients about the use of e-cigarettes, and a further 45 per cent said they did not know whether guidance existed.

“Smoking is a well-established risk factor for many common cancers. It is the single biggest avoidable cause of cancer in the world,” said Brett.

“Problems caused by smoking continue after a cancer diagnosis. It increases the risk of treatment complications, cancer recurrence and the development of a second primary tumour, leading to an increased risk of death. So it’s vital that these patients are encouraged to stop smoking,” she explained.

Brett continued: “E-cigarettes are now the most popular intervention for smoking cessation in the UK. However, little is known about health professionals’ knowledge and attitude towards e-cigarettes and whether they are endorsing use of e-cigarettes with cancer patients.”

There is significant debate over the risks posed by e-cigarettes. Certain British health bodies, such as the Royal College of Physicians, have provided their support for the use of e-cigarettes as a less harmful alternative to smoking. However, as reported by Dental Tribune International, studies published in the US and Canada have found that regular exposure to e-cigarette vapours causes damage to the gingival tissue, which may lead to infection, inflammation and periodontal disease. In addition, further research has found that e-cigarettes may modify the DNA of oral cells and increase cancer risks.

In April 2018, the National Institute for Health and Care Excellence and Public Health England published updated guidelines on smoking interventions and services. While they acknowledge that many people have found e-cigarettes helpful when quitting tobacco, the guidelines recommend that health and social care workers explain that evidence for their use is still developing, including research on their long-term health impact. 

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