Wednesday, August 13, 2014

North Carolina Physicians Endorse E-Cigarettes

A survey of North Carolina physicians documents that many understand the benefit of e-cigarettes and some actively recommend that their smoking patients switch.  The results were published in PLoS One by Kelly Kandra of Benedictine University and colleagues from Family Medicine at the University of North Carolina (available here).

From the published paper: “Over two-thirds (67.2%) of the physicians indicated that e-cigarettes are a helpful aid for smoking cessation, and 35.2% recommended them to their patients.  A majority (64.8%) believed that e-cigarettes lower the risk of cancer for patients who use them instead of smoking cigarettes.”

It is exceptionally good news that, despite a tsunami of misinformation about e-cigarettes from federal and state health officials and major medical societies, a majority of the state’s practicing physicians know that the devices are helping smokers quit and reducing risk exposure. 

Kandra and colleagues attempt to blunt the impact of their data, writing that “physicians should remain cautious until more data is available about recommending e-cigarettes as tobacco cessation tools in clinical practice in favor of more effective modalities.”  What are those “more effective modalities”?  Nicotine replacement therapy (with a success rate of 5%, only slightly higher than placebo), varenicline (Chantix, 7% success rate), and bupropion (5% success) (reference here).

One of the study’s authors, Dr. Adam Goldstein, declared in a press release: “Physicians may choose to use FDA approved medications rather than devices and products not approved by FDA.” 

In reality, physicians may also choose e-cigarettes after “approved medications” fail.  Doctors are well equipped to weigh the risks and the benefits of consuming nicotine in smoke-free forms, and counseling their patients accordingly.

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