Study shows many clinicians are unfamiliar with use of e-cigarettes with their young patients

The use of electronic cigarettes, battery operated devices that often look like cigarettes and deliver vaporized nicotine, is on the rise, including among minors. In a survey between 2011 and 2012, 10 percent of high school students reported ever using an e-cigarette. However, many clinicians are unfamiliar with or uncomfortable with addressing the use of e-cigarettes with their young patients, finds a new study in the Journal of Adolescent Health.

"The scientific community is still learning about e-cigarettes, and while there is much that we don't know, most people would probably agree that minors should not be using them," said lead author Jessica K. Pepper, M.P.H. of the University of North Carolina Grillings School of Global Public Health.

Pepper and her colleagues analyzed feedback from an online survey of 561 Minnesota health care providers who regularly see adolescent patients.

While 92 percent of the study respondents were aware of e-cigarettes and most were concerned that e-cigarettes could be a gateway to smoking, 83 percent admitted to knowing little to nothing at all about them. Only 11 percent of respondents had treated a teenager who had used e-cigarettes. In addition, most regarded e-cigarettes as somewhat less harmful than traditional cigarettes and smokeless tobacco and had based their impressions on information from the media or their patients. As a result, 92 percent expressed interest in wanting more evidence about e-cigarette risks and/or benefits so they could be better prepared to counsel adolescents.

Aleksandra Zgierska, M.D., Ph.D., assistant professor at the University of Wisconsin School of Medicine and Public Health, agreed with the study's findings and said preventive counseling is key to educating teens about health risks of smoking tobacco and using e-cigarettes.

"At our clinic, the staff is required to ask about smoking and tobacco use. The more we ask, the more we get, and research supports this," she said. "What worries me as a physician is that adolescents often think e-cigarettes are just a vapor—that they are fun, smart, and a perfectly safe alternative to smoking, but there are real risks related to e-cigarettes."

Pepper pointed out, "Providers in our study expressed a strong desire to learn more about e-cigarettes. As the evidence base increases, medical school, training programs and professional organizations should consider incorporating information about e-cigarettes into their guidance about behavioral counseling. This is not an issue that is going away any time soon."