Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece
Abstract
:1. Introduction
2. Methods
Statistical Analysis
3. Results
3.1. Descriptive Analysis of the Study Sample
3.2. Comparison between Smoking and Never Smoking Participants
3.3. Comparison Between Physicians and Nurses
3.4. Responses by Cardiologists and Respiratory Physicians
3.5. Knowledge Score
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Conflicts of Interest
References
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Participant Characteristics and Responses (n = 262) | Mean (SD) or n (%) |
---|---|
Gender | |
Males | 138 (52.7%) |
Females | 124 (47.3%) |
Age (Years) | 39 (9) |
Profession | |
Nurse | 77 (29.4%) |
Physician | 185 (70.6%) |
General practitioner | 17 (6.5%) |
Cardiologist | 53 (20.2%) |
Dentist | 32 (12.2%) |
Internist | 32 (12.2%) |
Pediatrician | 17 (6.5%) |
Respiratory physician | 34 (13.0%) |
Working Sector | |
Public sector | 162 (61.8%) |
Private sector | 100 (38.2%) |
Working time | 12 (8) |
Contact with smokers in the working environment | |
Daily | 222 (84.7%) |
At least 3 days per week | 15 (5.7%) |
1–2 days per weekly | 6 (2.3%) |
<1 day per week | 18 (6.9%) |
Smokers | 80 (30.5%) |
Consider quitting * | 48 (60.0%) |
Former smokers | 59 (22.5%) |
Smoking cessation method for former smokers | |
No aid | 47 (17.9%) |
Nicotine replacement therapy | 1 (0.4%) |
Oral medications | 3 (1.1%) |
Electronic cigarette | 7 (2.7%) |
Other | 1 (0.4%) |
Self-perceived level of knowledge about smoking | |
Very high | 99 (37.8%) |
Fairly high | 116 (44.3%) |
Moderate | 43 (16.4%) |
Low | 4 (1.5%) |
Risk score for products | |
Tobacco cigarettes | 9.3 (1.1) |
Snus | 8.3 (1.7) |
Electronic cigarettes | 5.9 (2.4) |
Nicotine replacement therapy | 4.0 (2.3) |
Oral medications | 4.2 (2.2) |
Risk score for smoking components | |
Nicotine | 8.0 (2.1) |
Inhaled smoke | 8.8 (1.4) |
Carbon monoxide | 9.1 (1.4) |
Tar | 9.5 (0.9) |
Tobacco | 6.7 (2.4) |
Contribution of nicotine to smoking-related disease | |
Extremely important | 63 (24.0%) |
Very important | 106 (40.5%) |
Important | 55 (21.0%) |
Less important | 26 (9.9%) |
Minimal | 12 (4.6%) |
Contribution of nicotine to lung cancer | |
Extremely important | 63 (24.8%) |
Very important | 86 (32.8%) |
Important | 49 (18.7%) |
Less important | 37 (14.1%) |
Minimal | 25 (9.5%) |
Contribution of nicotine to cancer in other organs | |
Extremely important | 28 (10.7%) |
Very important | 88 (33.6%) |
Important | 71 (27.1%) |
Less important | 53 (20.2%) |
Minimal | 22 (8.4%) |
Contribution of nicotine to atherosclerosis | |
Extremely important | 68 (26.0%) |
Very important | 105 (40.1%) |
Important | 50 (19.1%) |
Less important | 28 (10.7%) |
Minimal | 11 (4.2%) |
Risk of nicotine replacement therapies compared to smoking | |
Higher | 3 (1.1%) |
Equal | 42 (16.0%) |
Lower | 200 (76.3%) |
Do not know | 17 (6.5%) |
Dependence potential of nicotine replacement therapies compared to smoking | |
Higher | 3 (1.1%) |
Equal | 84 (32.1%) |
Lower | 146 (55.7%) |
Do not know | 29 (11.1%) |
Success rate of nicotine replacement therapies in smoking cessation at 1 year | |
>50% | 12 (4.6%) |
30%–50% | 63 (24.0%) |
10%–30% | 126 (48.1%) |
<10% | 61 (23.3%) |
Origin of nicotine in nicotine replacement therapies | |
Tobacco-extracted | 42 (16.0%) |
Synthetically-produced | 220 (84.0%) |
Safe to use nicotine replacement therapies for >6 months as substitutes to smoking? | |
Yes | 65 (24.8%) |
No | 197 (75.2%) |
Recommend the long-term (>6 months) use of nicotine replacement therapies for those who cannot reduce or quit smoking with short-term use? | |
Yes | 55 (21.0%) |
No | 207 (79.0%) |
Have you ever recommended e-cigarettes to smokers? | |
Yes | 87 (33.2%) |
No | 175 (66.8%) |
Risk of e-cigarettes compared to smoking | |
Higher | 4 (1.5%) |
Equal | 60 (22.9%) |
Lower | 174 (66.4%) |
Do not know | 24 (9.2%) |
Dependence potential of e-cigarettes compared to smoking | |
Higher | 6 (2.3%) |
Equal | 112 (42.7%) |
Lower | 120 (45.8%) |
Do not know | 24 (9.2%) |
Origin of nicotine in e-cigarettes | |
Tobacco-extracted | 34 (13.0%) |
Synthetically-produced | 228 (87.0%) |
Would you recommend e-cigarettes to smokers who refuse to take medications to quit? | |
Yes | 147 (56.1%) |
No | 115 (43.9%) |
Would you recommend e-cigarettes to smokers who failed to quit with other methods? | |
Yes | 156 (59.5%) |
No | 106 (40.5%) |
Which of the following are correct concerning e-cigarettes? | |
They contain tobacco | 19 (7.3%) |
There is combustion | 93 (35.5%) |
E-liquid ingredients are approved for inhalation | 172 (65.6%) |
Working temperature is lower than in tobacco cigarettes | 97 (37.0%) |
They have official quality certificates | 66 (25.2%) |
There are e-cigarettes without nicotine | 152 (58.0%) |
Do you consider e-cigarettes effective in substituting smoking? | |
Yes | 134 (51.1%) |
No | 128 (48.9%) |
What do you think regulation on e-cigarettes should include? | |
Available only through prescription | 114 (43.5%) |
Ban on nicotine | 115 (43.9%) |
No flavors | 52 (19.8%) |
Ban on the sales to youngsters | 193 (73.7%) |
Ban on the use in public places | 74 (28.2%) |
They should be licensed as medications | 113 (43.1%) |
They should be sold only in pharmacies | 100 (38.2%) |
Product variability should be reduced | 64 (24.4%) |
Advertising should be banned | 104 (39.7%) |
There should be a warning that they are equally harmful to Smoking | 110 (42.0%) |
Do you know the European Union regulatory framework on e-cigarettes? | |
Yes | 38 (14.5%) |
No | 223 (85.1%) |
Participant Characteristics and Responses (n = 262) | Smokers (Current and Former) | Never Smokers | p |
---|---|---|---|
139 (53.1%) | 123 (46.9%) | ||
Gender | |||
Males | 69 (49.6%) | 55 (44.7%) | 0.426 |
Females | 70 (50.4%) | 68 (55.3%) | |
Age (Years) | 39 (9.0%) | 39 (8.0%) | 0.462 |
Profession | |||
Nurse | 46 (33.1%) | 31 (25.2%) | 0.162 |
Physician | 93 (66.9%) | 92 (74.8%) | |
General practitioner | 10 (7.2%) | 7 (5.7%) | |
Cardiologist | 24 (17.3%) | 29 (23.6%) | |
Dentist | 18 (12.9%) | 14 (11.4%) | |
Internist | 14 (10.1%) | 18 (14.6%) | |
Pediatrician | 9 (6.5%) | 8 (6.5%) | |
Respiratory physician | 18 (12.9%) | 16 (13.0%) | |
Working sector | |||
Public sector | 88 (63.3%) | 74 (60.2%) | |
Private sector | 51 (36.7%) | 49 (39.8%) | |
Working time | 13 (8) | 12 (8) | 0.710 |
Contact with smokers in the working environment | |||
Daily | 117 (84.2%) | 105 (86.1%) | 0.919 |
At least 3 days per week | 8 (5.8%) | 7 (5.7%) | |
1–2 days per weekly | 3 (2.2%) | 3 (2.5%) | |
<1 day per week | 11 (7.9%) | 7 (5.7%) | |
Smoking cessation method for former smokers | |||
No aid | 47 (17.9%) | ||
Nicotine replacement therapy | 1 (0.4%) | ||
Oral medications | 3 (1.1%) | ||
Electronic cigarette | 7 (2.7%) | ||
Other | 1 (0.4%) | ||
Self-perceived level of knowledge about smoking | |||
Very high | 57 (41.0%) | 42 (34.1%) | 0.080 |
Fairly high | 63 (45.3%) | 53 (43.1%) | |
Moderate | 19 (13.7%) | 21 (19.5%) | |
Low | 0 (0.0%) | 4 (3.3%) | |
Risk score for products | |||
Tobacco cigarettes | 9.3 (1.2) | 9.4 (1.0) | 0.252 |
Snus | 7.8 (1.9) | 8.9 (1.2) | <0.001 |
Electronic cigarettes | 5.9 (2.4) | 5.9 (2.5) | 0.923 |
Nicotine replacement therapy | 4.3 (2.2) | 4.5 (2.3) | 0.529 |
Oral medications | 4.3 (2.3) | 4 (2.1) | 0.201 |
Risk score for smoking components | |||
Nicotine | 7.7 (2.4) | 8.3 (1.8) | 0.012 |
Inhaled smoke | 8.8 (1.4) | 8.9 (1.4) | 0.577 |
Carbon monoxide | 9.0 (1.5) | 9.2 (1.2) | 0.101 |
Tar | 9.6 (0.8) | 9.5 (1.0) | 0.386 |
Tobacco | 6.7 (2.5) | 6.7 (2.4) | 0.773 |
Contribution of nicotine to smoking-related disease | |||
Extremely important | 29 (20.9%) | 34 (27.6%) | 0.679 |
Very important | 57 (41.0%) | 49 (39.8%) | |
Important | 31 (22.3%) | 24 (19.5%) | |
Less important | 16 (11.5%) | 10 (8.1%) | |
Minimal | 6 (4.3%) | 6 (4.9%) | |
Contribution of nicotine to lung cancer | |||
Extremely important | 32 (23.0%) | 33 (26.8%) | 0.894 |
Very important | 48 (34.5%) | 38 (30.9%) | |
Important | 26 (18.7%) | 23 (18.7%) | |
Less important | 21 (15.1%) | 16 (13.0%) | |
Minimal | 12 (8.6%) | 13 (10.6%) | |
Contribution of nicotine to cancer in other organs | |||
Extremely important | 15 (10.8%) | 13 (10.6%) | 0.880 |
Very important | 46 (33.1%) | 42 (34.1%) | |
Important | 37 (26.6%) | 34 (27.6%) | |
Less important | 31 (22.3%) | 22 (17.9%) | |
Minimal | 10 (7.2%) | 12 (9.8%) | |
Contribution of nicotine to atherosclerosis | |||
Extremely important | 39 (28.1%) | 29 (23.6%) | 0.299 |
Very important | 60 (43.2%) | 45 (36.6%) | |
Important | 20 (14.4%) | 30 (24.4%) | |
Less important | 15 (10.8%) | 13 (10.6%) | |
Minimal | 5 (3.6%) | 6 (4.9%) | |
Risk of nicotine replacement therapies compared to smoking | |||
Higher | 1 (0.7%) | 2 (1.6%) | 0.302 |
Equal | 27 (19.4%) | 15 (12.2%) | |
Lower | 104 (74.8%) | 96 (78.0%) | |
Do not know | 7 (5.0%) | 10 (8.1%) | |
Dependence potential of nicotine replacement therapies compared to smoking | |||
Higher | 1 (0.7%) | 2 (1.6%) | 0.702 |
Equal | 48 (34.5%) | 36 (29.3%) | |
Lower | 74 (53.2%) | 72 (58.5%) | |
Do not know | |||
Success rate of nicotine replacement therapies in smoking cessation at 1 year | |||
>50% | 5 (3.6%) | 7 (5.7%) | 0.145 |
30%–50% | 28 (20.1%) | 35 (28.5%) | |
10%–30% | 67 (48.2%) | 59 (48.0%) | |
<10% | 39 (28.1%) | 22 (17.9%) | |
Origin of nicotine in nicotine replacement therapies | |||
Tobacco-extracted | 22 (15.8%) | 20 (16.3%) | 0.924 |
Synthetically-produced | 117 (84.2%) | 103 (83.7%) | |
Safe to use nicotine replacement therapies for >6 months as substitutes to smoking? | |||
Yes | 35 (25.2%) | 30 (24.4%) | 0.883 |
No | 104 (74.8%) | 93 (75.6%) | |
Recommend the long-term (>6 months) use of nicotine replacement therapies for those who cannot reduce or quit smoking with short-term use? | |||
Yes | 26 (18.7%) | 29 (23.6%) | 0.334 |
No | 113 (81.3%) | 94(76.4%) | |
Have you ever recommended e-cigarettes to smokers? | |||
Yes | 46 (33.1%) | 41 (33.3%) | 0.967 |
No | 93 (66.9%) | 82 (66.7%) | |
Risk of e-cigarettes compared to smoking | |||
Higher | 1 (0.7%) | 3(1.1%) | 0.451 |
Equal | 36 (25.9%) | 24 (19.5%) | |
Lower | 90 (64.7%) | 84 (68.3%) | |
Do not know | 12 (8.6%) | 12 (9.8%) | |
Dependence potential of e-cigarettes compared to smoking | |||
Higher | 4 (2.9%) | 2 (1.6%) | 0.649 |
Equal | 63 (45.3%) | 49 (39.8%) | |
Lower | 61 (43.9%) | 59 (48.0%) | |
Do not know | 11 (7.9%) | 13 (10.6%) | |
Origin of nicotine in e-cigarettes | |||
Tobacco-extracted | 20 (14.4%) | 14 (11.4%) | 0.470 |
Synthetically-produced | 119 (85.6%) | 109 (88.6%) | |
Would you recommend e-cigarettes to smokers who refuse to take medications to quit? | |||
Yes | 81 (58.3%) | 66 (53.7%) | 0.453 |
No | 58 (41.7%) | 57 (46.3%) | |
Would you recommend e-cigarettes to smokers who failed to quit with other methods? | |||
Yes | 82 (59.0%) | 74 (60.2%) | 0.847 |
No | 57 (41.0%) | 49 (39.8%) | |
Which of the following are correct concerning e-cigarettes? | |||
They contain tobacco | 11 (7.9%) | 8 (6.5%) | 0.661 |
There is combustion | 51 (36.7%) | 42 (34.1%) | 0.668 |
E-liquid ingredients are approved for inhalation | 92 (66.2%) | 80 (65.0%) | 0.845 |
Working temperature is lower than in tobacco cigarettes | 49 (35.3%) | 48 (39.0%) | 0.528 |
They have official quality certificates | 36 (25.9%) | 30 (24.4%) | 0.779 |
There are e-cigarettes without nicotine | 86 (61.9%) | 66 (53.7%) | 0.179 |
Do you consider e-cigarettes effective in substituting smoking? | |||
Yes | 69 (49.6%) | 65 (52.8%) | 0.604 |
No | 70 (50.4%) | 58 (47.2%) | |
What do you think regulation on e-cigarettes should include? | |||
Available only through prescription | 56 (40.3%) | 61 (49.6%) | 0.131 |
Ban on nicotine | 48 (34.5%) | 67 (54.5%) | 0.001 |
No flavors | 35 (25.2%) | 17 (13.8%) | 0.021 |
Ban on the sales to youngsters | 104 (74.8%) | 89 (72.4%) | 0.652 |
Ban on the use in public places | 33 (23.7%) | 41 (33.3%) | 0.085 |
They should be licensed as medications | 56 (40.3%) | 57 (46.3%) | 0.323 |
They should be sold only in pharmacies | 46 (33.1%) | 54 (43.9%) | 0.072 |
Product variability should be reduced | 36 (25.9%) | 28 (22.8%) | 0.556 |
Advertising should be banned | 53 (38.1%) | 51 (41.5%) | 0.582 |
There should be a warning that they are equally harmful to smoking | 62 (44.6%) | 48 (39.0%) | 0.361 |
Do you know the European Union regulatory framework on e-cigarettes? | |||
Yes | 17 (12.2%) | 21 (12.2%) | 0.255 |
No | 122 (87.8%) | 101 (82.8%) |
Participant Characteristics and Responses (n = 262) | Physicians | Nurses | p |
---|---|---|---|
185 (70.6%) | 77 (29.4%) | ||
Gender | |||
Males | 109 (58.9%) | 15 (19.5%) | <0.001 |
Females | 76 (41.1%) | 62 (81.5%) | |
Age | 41 (8) | 33 (6) | <0.001 |
Working sector | |||
Public sector | 98 (53.0%) | 64 (83.1%) | <0.001 |
Private sector | 87 (47.0%) | 13 (16.9%) | |
Working time | 14 (9) | 9 (5) | <0.001 |
Contact with smokers in the working environment | |||
Daily | 159 (85.9%) | 63 (82.9%) | 0.676 |
At least 3 days per week | 11 (5.9%) | 4 (5.3%) | |
1–2 days per weekly | 3 (1.6%) | 3 (3.9%) | |
<1 day per week | 12 (6.5%) | 6 (7.9%) | |
Smokers | 44 (23.8%) | 36 (46.8%) | <0.001 |
Consider quitting * | 25 (56.8%) | 23 (63.9%) | 0.521 |
Former smokers | 49 (34.8%) | 10 (24.4%) | 0.212 |
Smoking cessation method for former smokers | |||
No aid | 39 (79.6%) | 8 (80.0%) | 0.792 |
Nicotine replacement therapy | 1 (2.0%) | 0 (0.0%) | |
Oral medications | 3 (6.1%) | 0 (0.0%) | |
Electronic cigarette | 5 (10.2%) | 2 (20.0%) | |
Other | 1 (2.0%) | 0 (0.0%) | |
Self-perceived level of knowledge about smoking | |||
Very high | 80 (43.2%) | 19 (24.7%) | 0.006 |
Fairly high | 79 (42.7%) | 37 (48.1%) | |
Moderate | 25 (13.5%) | 18 (23.4%) | |
Low | 1 (0.5%) | 3 (3.9%) | |
Risk score for products | |||
Tobacco cigarettes | 9.5 (0.9) | 9.0 (1.7) | 0.008 |
Snus | 8.3 (1.7) | 8.3 (1.6) | 0.952 |
Electronic cigarettes | 6.0 (2.4) | 5.7 (2.5) | 0.240 |
Nicotine replacement therapy | 4.2 (2.2) | 5.0 (2.2) | 0.005 |
Oral medications | 3.8 (2.1) | 5.1 (2.3) | <0.001 |
Risk score for smoking components | |||
Nicotine | 7.8 (2.3) | 8.5 (1.6) | 0.005 |
Inhaled smoke | 9.0 (1.3) | 8.4 (1.5) | 0.007 |
Carbon monoxide | 9.1 (1.4) | 9.1 (1.3) | 0.794 |
Tar | 9.6 (0.9) | 9.5 (0.9) | 0.496 |
Tobacco | 6.6 (2.4) | 6.9 (2.4) | 0.401 |
Contribution of nicotine to smoking-related disease | |||
Extremely important | 42 (22.7%) | 21 (27.3%) | 0.011 |
Very important | 65 (35.1%) | 41 (53.2%) | |
Important | 45 (24.3%) | 10 (13.0%) | |
Less important | 23 (12.4%) | 3 (3.9%) | |
Minimal | 10 (5.4%) | 2 (2.6%) | |
Contribution of nicotine to lung cancer | |||
Extremely important | 43 (23.2%) | 22 (28.6%) | <0.001 |
Very important | 47 (25.4%) | 39 (50.6%) | |
Important | 38 (20.5%) | 11 (14.3%) | |
Less important | 34 (18.4%) | 3 (3.9%) | |
Minimal | 23 (12.4%) | 2 (2.6%) | |
Contribution of nicotine to cancer in other organs | |||
Extremely important | 21 (11.4%) | 7 (9.1%) | 0.007 |
Very important | 51 (27.6%) | 37 (48.1%) | |
Important | 50 (27.0%) | 21 (27.3%) | |
Less important | 43 (23.2%) | 10 (13.0%) | |
Minimal | 20 (10.8%) | 2 (2.6%) | |
Contribution of nicotine to atherosclerosis | |||
Extremely important | 45 (24.3%) | 23 (29.9%) | <0.001 |
Very important | 62 (33.5%) | 43 (55.8%) | |
Important | 42 (22.7%) | 8 (10.4%) | |
Less important | 26 (14.1%) | 2 (2.6%) | |
Minimal | 10 (5.4%) | 1 (1.3%) | |
Risk of nicotine replacement therapies compared to smoking | |||
Higher | 2 (1.1%) | 1 (1.3%) | 0.044 |
Equal | 23 (12.4%) | 19 (24.7%) | |
Lower | 150 (81.1%) | 50 (64.9%) | |
Do not know | 10 (5.4%) | 7 (9.1%) | |
Dependence potential of nicotine replacement therapies compared to smoking | |||
Higher | 3 (1.6%) | 0 (0.0%) | 0.006 |
Equal | 53 (28.6%) | 31 (40.3%) | |
Lower | 114 (61.6%) | 32 (41.6%) | |
Do not know | 15 (8.1%) | 14 (18.2%) | |
Success rate of nicotine replacement therapies in smoking cessation at 1 year | |||
>50% | 8 (4.3%) | 4 (5.2%) | 0.991 |
30%–50% | 45 (24.3%) | 18 (23.4%) | |
10%–30% | 89 (48.1%) | 37 (48.1%) | |
<10% | 43 (23.2%) | 18 (23.4%) | |
Origin of nicotine in nicotine replacement therapies | |||
Tobacco-extracted | 32 (17.3%) | 10 (13.0%) | 0.386 |
Synthetically-produced | 153 (82.7%) | 67 (87.0%) | |
Safe to use nicotine replacement therapies for >6 months as substitutes to smoking? | |||
Yes | 53 (28.6%) | 12 (15.6%) | 0.026 |
No | 132 (71.4%) | 65 (84.4%) | |
Recommend the long-term (>6 months) use of nicotine replacement therapies for those who cannot reduce or quit smoking with short-term use? | |||
Yes | 45 (24.3%) | 10 (13.0%) | 0.040 |
No | 140 (75.7%) | 67 (87.0%) | |
Have you ever recommended e-cigarettes to smokers? | |||
Yes | 58 (31.4%) | 29 (37.7%) | 0.323 |
No | 127 (68.6%) | 48 (62.3%) | |
Risk of e-cigarettes compared to smoking | |||
Higher | 4 (2.2%) | 0 (0.0%) | 0.542 |
Equal | 43 (23.2%) | 17 (22.1%) | |
Lower | 120 (64.9%) | 54 (70.1%) | |
Do not know | 18 (9.7%) | 6 (7.8%) | |
Dependence potential of e-cigarettes compared to smoking | |||
Higher | 5 (2.7%) | 1 (1.3%) | 0.212 |
Equal | 75 (40.5%) | 37 (48.1%) | |
Lower | 91 (49.2%) | 29 (37.7%) | |
Do not know | 14 (7.6%) | 10 (13.0%) | |
Origin of nicotine in e-cigarettes | |||
Tobacco-extracted | 25 (13.5%) | 9 (11.7%) | 0.689 |
Synthetically-produced | 160 (86.5%) | 68 (88.3%) | |
Would you recommend e-cigarettes to smokers who refuse to take medications to quit? | |||
Yes | 95 (51.4%) | 52 (67.5%) | 0.016 |
No | 90 (48.6%) | 25 (32.5%) | |
Would you recommend e-cigarettes to smokers who failed to quit with other methods? | |||
Yes | 104 (56.2%) | 52 (67.5%) | 0.089 |
No | 81 (43.8%) | 25 (32.5%) | |
Which of the following are correct concerning e-cigarettes? | |||
They contain tobacco | 11 (5.9%) | 8 (10.4%) | 0.206 |
There is combustion | 68 (36.8%) | 25 (32.5%) | 0.509 |
E-liquid ingredients are approved for inhalation | 114 (61.6%) | 58 (75.3%) | 0.033 |
Working temperature is lower than in tobacco cigarettes | 72 (38.9%) | 25 (32.5%) | 0.325 |
They have official quality certificates | 40 (21.6%) | 26 (39.4%) | 0.039 |
There are e-cigarettes without nicotine | 109 (58.9%) | 43 (55.8%) | 0.646 |
Do you consider e-cigarettes effective in substituting smoking? | |||
Yes | 91 (49.2%) | 43 (55.8%) | 0.326 |
No | 94 (50.8%) | 34 (44.2%) | |
What do you think regulation on e-cigarettes should include? | |||
Available only through prescription | 81 (43.8%) | 36 (46.8%) | 0.660 |
Ban on nicotine | 76 (41.1%) | 39 (50.6%) | 0.155 |
No flavors | 38 (20.5%) | 14 (18.2%) | 0.663 |
Ban on the sales to youngsters | 141 (76.2%) | 52 (67.5%) | 0.146 |
Ban on the use in public places | 61 (33.0%) | 13 (16.9%) | 0.008 |
They should be licensed as medications | 84 (45.4%) | 29 (37.7%) | 0.249 |
They should be sold only in pharmacies | 75 (40.5%) | 25 (32.5%) | 0.220 |
Product variability should be reduced | 46 (24.9%) | 18 (23.4%) | 0.798 |
Advertising should be banned | 81 (43.8%) | 23 (29.9%) | 0.036 |
There should be a warning that they are equally harmful to smoking | 73 (39.5%) | 37 (48.1%) | 0.199 |
Do you know the European Union regulatory framework on e-cigarettes? | |||
Yes | 34 (18.5%) | 4 (5.2%) | 0.006 |
No | 150 (81.5%) | 73 (94.8%) |
Participant Characteristics and Responses (n = 262) | Cardiologists and Respiratory Physicians | All Others | p |
---|---|---|---|
87 (33.2%) | 175 (66.8%) | ||
Gender | |||
Males | 58 (66.7%) | 66 (37.7%) | <0.001 |
Females | 29 (33.3%) | 109 (62.3%) | |
Age | 43 (9) | 37 (8) | <0.001 |
Working sector | |||
Public sector | 49 (56.3%) | 113 (64.6%) | 0.195 |
Private sector | 38 (43.7%) | 62 (35.4%) | |
Working time | 15 (9) | 11 (7) | 0.001 |
Contact with smokers in the working environment | |||
Daily | 82 (94.3%) | 140 (80.5%) | 0.013 |
At least 3 days per week | 4 (4.6%) | 11 (6.3%) | |
1–2 days per weekly | 0 (0.0%) | 6 (3.4%) | |
<1 day per week | 1 (1.1%) | 17 (9.8%) | |
Smokers | 18 (20.7%) | 62 (35.4%) | 0.015 |
Consider quitting * | 12 (66.7%) | 36 (58.1%) | 0.512 |
Former smokers | 24 (34.8%) | 35 (31.0%) | 0.594 |
Smoking cessation method for former smokers | |||
No aid | 19 (79.2%) | 28 (80.0%) | 0.017 |
Nicotine replacement therapy | 1 (4.2%) | 0 (0.0%) | |
Oral medications | 3 (12.5%) | 0 (0.0%) | |
Electronic cigarette | 0 (0.0%) | 7 (20.0%) | |
Other | 1 (4.2%) | 0 (0.0%) | |
Self-perceived level of knowledge about smoking | |||
Very high | 46 (52.9%) | 53 (30.3%) | 0.003 |
Fairly high | 30 (34.5%) | 86 (49.1%) | |
Moderate | 11 (12.6%) | 32 (18.3%) | |
Low | 0 (0.0%) | 4 (2.3%) | |
Risk score for products | |||
Tobacco cigarettes | 9.6 (0.7) | 9.2 (1.2) | <0.001 |
Snus | 8.3 (1.6) | 8.3 (1.7) | 0.921 |
Electronic cigarettes | 6.7 (2.4) | 5.6 (2.4) | <0.001 |
Nicotine replacement therapy | 4.1 (2.5) | 4.5 (2.1) | 0.292 |
Oral medications | 3.8 (2.4) | 4.3 (2.1) | 0.049 |
Risk score for smoking components | |||
Nicotine | 7.8 (2.3) | 8.1 (2.1) | 0.327 |
Inhaled smoke | 9.2 (1.2) | 8.6 (1.5) | 0.002 |
Carbon monoxide | 9.1 (1.4) | 9.1 (1.3) | 0.725 |
Tar | 9.6 (0.9) | 9.5 (0.9) | 0.225 |
Tobacco | 6.5 (2.5) | 6.8 (2.4) | 0.292 |
Contribution of nicotine to smoking-related disease | |||
Extremely important | 18 (20.7%) | 45 (25.7%) | 0.305 |
Very important | 32 (36.8%) | 74 (42.3%) | |
Important | 25 (28.7%) | 30 (17.1%) | |
Less important | 8 (9.2%) | 18 (10.3%) | |
Minimal | 4 (4.6%) | 8 (4.6%) | |
Contribution of nicotine to lung cancer | |||
Extremely important | 20 (23.0%) | 45 (25.7%) | 0.130 |
Very important | 23 (26.4%) | 63 (36.0%) | |
Important | 15 (17.2%) | 34 (19.4%) | |
Less important | 17 (19.5%) | 20 (11.4%) | |
Minimal | 12 (13.8%) | 13 (7.4%) | |
Contribution of nicotine to cancer in other organs | |||
Extremely important | 11 (12.6%) | 17 (9.7%) | 0.186 |
Very important | 29 (33.3%) | 59 (33.7%) | |
Important | 17 (19.5%) | 54 (30.9%) | |
Less important | 19 (21.8%) | 34 (19.4%) | |
Minimal | 11 (6.3%) | 11 (12.6%) | |
Contribution of nicotine to atherosclerosis | |||
Extremely important | 25 (28.7%) | 43 (24.6%) | 0.040 |
Very important | 25 (28.7%) | 80 (45.7%) | |
Important | 18 (20.7%) | 32 (18.3%) | |
Less important | 15 (17.2%) | 13 (7.4%) | |
Minimal | 4 (4.6%) | 7 (4.0%) | |
Risk of nicotine replacement therapies compared to smoking | |||
Higher | 2 (2.3%) | 1 (0.6%) | 0.135 |
Equal | 9 (10.3%) | 33 (18.9%) | |
Lower | 72 (82.8%) | 128 (73.1%) | |
Do not know | 4 (4.6%) | 13 (7.4%) | |
Dependence potential of nicotine replacement therapies compared to smoking | |||
Higher | 2 (2.3%) | 1 (0.6%) | 0.137 |
Equal | 27 (31.0%) | 57 (32.6%) | |
Lower | 53 (60.9%) | 93 (53.1%) | |
Do not know | 5 (5.7%) | 24 (13.7%) | |
Success rate of nicotine replacement therapies in smoking cessation at 1 year | |||
>50% | 5 (5.7%) | 7 (4.0%) | 0.660 |
30%–50% | 24 (27.6%) | 39 (22.3%) | |
10%–30% | 38 (43.7%) | 88 (50.3%) | |
<10% | 20 (23.0%) | 41 (23.4%) | |
Origin of nicotine in nicotine replacement therapies | |||
Tobacco-extracted | 16 (18.4%) | 26 (14.9%) | 0.463 |
Synthetically-produced | 71 (81.6%) | 149 (85.1%) | |
Safe to use nicotine replacement therapies for >6 months as substitutes to smoking? | |||
Yes | 26 (29.9%) | 39 (22.3%) | 0.180 |
No | 61 (70.1%) | 136 (77.7%) | |
Recommend the long-term (>6 months) use of nicotine replacement therapies for those who cannot reduce or quit smoking with short-term use? | |||
Yes | 23 (26.4%) | 32 (18.3%) | 0.127 |
No | 64 (73.6%) | 143 (81.7%) | |
Have you ever recommended e-cigarettes to smokers? | |||
Yes | 21 (24.1%) | 66 (37.7%) | 0.028 |
No | 66 (75.9%) | 109 (62.3%) | |
Risk of e-cigarettes compared to smoking | |||
Higher | 4 (4.6%) | 0 (0.0%) | 0.006 |
Equal | 26 (29.9%) | 34 (19.4%) | |
Lower | 50 (57.5%) | 124 (70.9%) | |
Do not know | 7 (8.0%) | 17 (9.7%) | |
Dependence potential of e-cigarettes compared to smoking | |||
Higher | 3 (3.4%) | 3 (1.7%) | 0.160 |
Equal | 44 (50.6%) | 68 (38.9%) | |
Lower | 35 (40.2%) | 85 (48.6%) | |
Do not know | 5 (5.7%) | 19 (10.9%) | |
Origin of nicotine in e-cigarettes | |||
Tobacco-extracted | 12 (13.8%) | 22 (12.6%) | 0.782 |
Synthetically-produced | 75 (86.2%) | 153 (87.4%) | |
Would you recommend e-cigarettes to smokers who refuse to take medications to quit? | |||
Yes | 34 (39.1%) | 113 (64.6%) | <0.001 |
No | 53 (60.9%) | 62 (35.4%) | |
Would you recommend e-cigarettes to smokers who failed to quit with other methods? | |||
Yes | 41 (47.1%) | 115 (65.7%) | 0.004 |
No | 46 (52.9%) | 60 (34.3%) | |
Which of the following are correct concerning e-cigarettes? | |||
They contain tobacco | 5 (5.7%) | 14 (8.0%) | 0.508 |
There is combustion | 32 (36.8%) | 61 (34.9%) | 0.759 |
E-liquid ingredients are approved for inhalation | 53 (60.9%) | 119 (68.0%) | 0.256 |
Working temperature is lower than in tobacco cigarettes | 34 (39.1%) | 63 (36.0%) | 0.627 |
They have official quality certificates | 16 (18.4%) | 50 (28.6%) | 0.074 |
There are e-cigarettes without nicotine | 55 (63.2%) | 97 (55.4%) | 0.229 |
Do you consider e-cigarettes effective in substituting smoking? | |||
Yes | 35 (40.2%) | 99 (56.6%) | 0.013 |
No | 52 (59.8%) | 76 (43.4%) | |
What do you think regulation on e-cigarettes should include? | |||
Available only through prescription | 35 (40.2%) | 82 (46.9%) | 0.310 |
Ban on nicotine | 30 (34.5%) | 85 (48.6%) | 0.030 |
No flavors | 20 (23.0%) | 32 (18.3%) | 0.369 |
Ban on the sales to youngsters | 72 (82.8%) | 121 (69.1%) | 0.018 |
Ban on the use in public places | 38 (43.7%) | 36 (20.6%) | <0.001 |
They should be licensed as medications | 43 (49.4%) | 70 (40.0%) | 0.147 |
They should be sold only in pharmacies | 34 (39.1%) | 66 (37.7%) | 0.830 |
Product variability should be reduced | 24 (27.6%) | 40 (22.9%) | 0.401 |
Advertising should be banned | 45 (51.7%) | 59 (33.7%) | 0.005 |
There should be a warning that they are equally harmful to smoking | 40 (46.0%) | 70 (40.0%) | 0.356 |
Do you know the European Union regulatory framework on e-cigarettes? | |||
Yes | 23 (26.4%) | 15 (8.6%) | <0.001 |
No | 64 (73.6%) | 159 (91.4%) |
© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
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Moysidou, A.; Farsalinos, K.E.; Voudris, V.; Merakou, K.; Kourea, K.; Barbouni, A. Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece. Int. J. Environ. Res. Public Health 2016, 13, 514. https://doi.org/10.3390/ijerph13050514
Moysidou A, Farsalinos KE, Voudris V, Merakou K, Kourea K, Barbouni A. Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece. International Journal of Environmental Research and Public Health. 2016; 13(5):514. https://doi.org/10.3390/ijerph13050514
Chicago/Turabian StyleMoysidou, Anastasia, Konstantinos E. Farsalinos, Vassilis Voudris, Kyriakoula Merakou, Kallirrhoe Kourea, and Anastasia Barbouni. 2016. "Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece" International Journal of Environmental Research and Public Health 13, no. 5: 514. https://doi.org/10.3390/ijerph13050514