To Counsel Patients on e-Cigarette Use, More Information Is Needed


E-cigarettes may be helpful for smoking cessation.

Electronic cigarettes may help people quit smoking, but health care providers need more information to talk with patients about them, according to a new study.

There is no evidence to date suggesting e-cigarettes are harmless, but numerous studies suggest they have lower levels of toxins than cigarettes and cigars. A survey of providers from 2018 and 2019 found more than 60% incorrectly believed that all tobacco products are equally harmful, according to the researchers.

“As the evidence grows showing e-cigarettes as potentially effective for smoking cessation, they may play a pivotal role in reducing use of cigarettes and subsequently tobacco-caused disease,” study author Michael Steinberg, MD, said in a press release.1

“It’s important to understand [providers’] perspectives on e-cigarettes as a means for harm reduction,” said Steinberg, who is medical director of the Rutgers Tobacco Dependence Program at the Center for Tobacco Studies and division chief in the Department of Medicine at the Rutgers Robert Wood Johnson Medical School.

About 480,000 people die each year in the United States from smoking tobacco.2

Instead of burning tobacco, e-cigarettes use a heated liquid containing nicotine. They are known as vapes, vaporizers, vape pens, hookah pens and other names, a formally as electronic nicotine delivery systems.

The study noted the FDA has not approved e-cigarettes as a cessation device.

Many people ask their health care providers about using them as an alternative to tobacco cigarettes or as a way to help them stop smoking. Nearly 70% of the providers reported patients have asked them about e-cigarettes, and one-third said they were asked in the past 30 days.

“These findings show it is critical to address physicians’ misperceptions and educate them on e-cigarettes’ efficacy, particularly correcting their misperceptions that all tobacco products are equally harmful, as opposed to the fact that combusted tobacco is by far the most dangerous,” lead author Cristine Delnevo, said in a press release. Delnevo is director of the Rutgers Center for Tobacco Studies and professor of Health Behavior, Society and Policy in the Rutgers School of Public Health.

Researchers surveyed 2,058 United States health care providers about their communication with patients about e-cigarettes, and about hypothetical examples.

The researchers asked how they would advise 2 different patients who wanted to quit smoking: a young woman who is a lighter smoker and had not yet tried to quit and an older man who smoked heavily and had tried to quit many times using different methods.

The study found that providers were significantly more likely to recommend e-cigarettes for the heavy smoker while recommending FDA-approved medications, like nicotine gum or lozenges, for the light smoker.

This article originally appeared on Medical Economics.


  1. Many physicians have misconceptions about e-cigarettes. News release. Rutgers University. April 15, 2022. Accessed April 20, 2022.
  2. Smoking and tobacco use. CDC. Reviewed June 2, 2021. Accessed April 20, 2022.
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