Canadian physicians are ill prepared to talk to smokers about alternatives to tobacco products

Health Canada or a professional association should provide guidance to physicians helping smokers quit

VANCOUVER, Sept. 3, 2019 /CNW/ - Canadian physicians appear to be ill prepared when it comes to discussing the variety of alternatives available to help smokers quit, according to a survey conducted for the Consumers' Association of Canada by Research Co. Only 25% of the 456 physicians surveyed recommended electronic nicotine delivery systems (ENDS) within the past year even though 63% believe them to be less harmful than cigarettes.

When asked if they read research on ENDS and discussed it with patients looking to quit smoking, only 37% of physicians had done so within the past month six months.  A troubling statistic when we consider the number of people who credit these products for helping them to become smoke-free.

Vaping products are the most common type of ENDS and are devices that do not burn or use tobacco leaves but instead heat up to vaporize a solution the user then inhales. (https://www.who.int/tobacco/communications/statements/eletronic-cigarettes-january-2017/en/)

"The number of smokers interested in ENDS has likely increased since vaping products were legalized in 2018, but Canadian physicians are not up to speed on these products nor given any formal guidance by governments or medical associations that would help them to confidently recommend vaping as a real alternative to smoking," said Bruce Cran, President of the Consumers' Association of Canada.

The picture is very different in other countries, particularly in England, where professional medical associations like the National Institute for Health Care Excellence (NICE) and bodies such as the Public Health England offer evidence summaries and practical guidance to their members. In a Guideline published in March 2018, NICE states that smokers should be told that many people have found e-cigarettes helpful aids to cessation and the evidence indicates that e-cigarettes are substantially less harmful to health than smoking, although not risk free.

Public Health England goes as far as to recommend that vaping products should be prescribed to smokers, in a report published in February 2018 (https://www.gov.uk/government/news/phe-publishes-independent-expert-e-cigarettes-evidence-review) and two hospitals in England now allow vape shops to support their move to become smoke free premises. (https://www.nytimes.com/2019/07/10/world/europe/uk-hospitals-vaping-shops.html)

Although Health Canada has recognized on its website that ENDS deliver nicotine in a less harmful way than smoking and that it may help smokers quit, (https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/smokers.html) it offers no guidance to health care practitioners who routinely have conversations with smokers.

"The gap between the number of physicians who believe that vaping is less harmful than smoking with the number of physicians actually recommending these products to smokers demonstrates the need for Health Canada or a professional association to step up and provide some guidance on vaping products," said Cran. "There are various studies that show vaping is a less risky way to consume nicotine and the more smokers turn to vaping, the more the harms associated with smoking are reduced."

But there is also a great deal of negative information on vaping. Physicians should not be left to their own to sift through the research to form a medical opinion. Offering reliable, practical guidance to physicians will ensure that physicians, in turn, are able to fulfil their responsibility to make smokers fully aware of all options that are available.

Although vaping products are less harmful than cigarettes, they do contain nicotine and are not harmless. For that reason, the CAC supports government regulations to keep vaping products out of the hands of Canadian youth while allowing proper communication and access to information so adult consumers can make informed choices.

Results from survey include:

• Over the course of the past year, only 25% (29% in Western Canada and 21% in Eastern Canada) of physicians surveyed have recommended that patients who currently smoke tobacco products use electronic nicotine delivery systems to help them reduce or quit their tobacco consumption while 75% have not (71% in the West and 79% in the East).
• 63% of the physicians (63% in the West and 61% in the East) believe that electronic nicotine delivery systems represent a harm reduction approach for patients who currently smoke traditional cigarettes while 26% do not (21% in Western Canada and 32% in Eastern Canada). 11% of the physicians are not sure (15% in the West and 8% in the East).
• Of the physicians surveyed, 37% have read research on electronic nicotine delivery systems (vaping devices, electronic cigarettes) within the past 6 months discussed it with patients (42% in the West and 32% in the East, 29% more than 6 months ago (18% in the West and 40% in the East), while 34% have not read research (40% in Western Canada and 28% in the East).

About the survey: Results are based on an online study conducted from July 9 to July 16, 2019, among 456 General Practitioners in Canada. The data has been statistically weighted according to Canadian census figures for age, gender and region in Canada. The margin of error—which measures sample variability—is +/- 3.1 percentage points for the sample of Canadians and +/- 3.9 percentage points for the sample of current or former smokers, nineteen times out of twenty.

SOURCE Consumers'' Association of Canada

Bruce Cran, Telephone: [phone]; To arrange an interview with Bruce Cran, please contact: Laird Greenshields, Telephone: [phone], Cell Phone: [phone]