Australian general practitioners' knowledge, attitudes and prescribing intentions for e-cigarettes as a smoking cessation aid: a nationwide baseline and 12-month follow up survey.

Abstract

Background: The Australian Government introduced a major policy change tightening regulations regarding the access to nicotine containing e-cigarettes in October 2021. We assessed general practitioners' (GPs) knowledge, attitudes, beliefs and intentions to prescribe nicotine containing e-cigarettes for smoking cessation. We compared baseline data near the time of policy change with data collected from these GPs 12-months later.

Methods: GPs were invited to complete a repeated cross-sectional survey based on the Theory of Planned Behaviour between December 2021 and March 2022 (T1) and again, between January and April 2023 (T2). Survey questions assessed knowledge, attitudes, beliefs and intention to prescribe e-cigarettes for smoking cessation.

Results: A total of 264 GPs completed the baseline (T1) survey and 94 provided responses at follow-up (T2). Over half of responders were female (T1 n = 170, 64.4%, T2 n = 57, 60.6%) and roughly one third were aged between 30 and 39 years (T1 n = 80, 37.2%, T2 n = 28, 29.8%). Participants who agreed e-cigarettes were suitable smoking cessation aids were more willing to recommend e-cigarettes to patients at T1 and T2 (T1 n = 29, 87.9%, vs. T2 n = 20, 100%). Knowledge about e-cigarettes was limited and did not change between T1 and T2. Participants who had greater confidence in their ability to talk to and answer patient questions about e-cigarettes were more likely to recommend them for smoking cessation at both T1 and T2 (T1 n = 24, 70.6% vs. T2 n = 17, 85.0%).

Conclusion: Since tightening the regulation of nicotine containing e-cigarettes, there has been little change in Australian GPs' perceptions of e-cigarettes as smoking cessation aids. Australian GPs are poorly educated about vaping and knowledge about e-cigarettes remained limited, however, GPs at follow-up were more confident in their ability to discuss e-cigarettes with their patients. The findings from this survey may help guide policy and develop strategies to support the implementation of smoking cessation guidelines that incorporate the use of e-cigarettes as smoking cessation aids in Australia.