Beliefs and self-reported practices of healthcare professionals regarding electronic nicotine delivery systems (ENDS): a mixed-methods systematic review and synthesis
A partir d'une revue systématique de la littérature publiée depuis 2003 (45 articles), cette étude analyse les comportements des professionnels de santé vis-à-vis des cigarettes électroniques en tant qu'aide au sevrage tabagique et/ou à la réduction du risque
This review explores the beliefs and attitudes of healthcare professionals (HCPs) towards electronic nicotine delivery systems (ENDS) including use as a smoking cessation aid and/or harm reduction, safety and regulation, and (2) the extent and content of patient-HCP communication about ENDS.PubMed, Embase, CINAHL, and PsycINFO were searched to identify articles published since 2003. The Mixed Methods Appraisal Tool (MMAT) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists were employed to assess the quality of studies. Thematic synthesis was employed to analyse qualitative data.A total of 45 articles (32 quantitative, 12 qualitative and 1 mixed) were included. There was wide variation regarding beliefs about the efficacy of ENDS as a cessation aid. Although the majority of HCPs believes that ENDS are safer than combustible cigarettes, they also have concern about the short and long-term safety of ENDS, uptake by adolescents, and the potential for ENDS to act as a ‘gateway’ to smoking cigarettes. Beliefs about ENDS are influenced by media stories and experiences provided by patients. While most HCPs do not proactively recommend ENDS, they are more likely to support ENDS use among patients with smoking related co-morbidities, heavy smokers with previous unsuccessful quit attempts, or patients who express interest in trying them.Overall, HCPs hold diverse views about the efficacy of ENDS and expressed wariness over their potential health effects. HCP endorsement of ENDS use seems to depend largely on patient health status, the presence of other competing risk factors and patient preferencesWhile evidence on safety and efficacy of ENDS is emerging, HCPs should be honest with their clients, stating that the long-term safety is not yet established but what is known is that they appear to be a lower risk alternative to cigarettes. Our review highlights a need for further training and support for HCPs regarding ENDS use, which would enable them to guide their clients in making evidence-based decisions.