Electronic nicotine delivery systems ("e-cigarettes"): review of safety and smoking cessation efficacy.

BACKGROUND AND OBJECTIVES: Cigarette smoking is common among cancer patients and is associated with negative outcomes. Electronic nicotine delivery systems ("e-cigarettes") are rapidly growing in popularity and use, but there is limited information on their safety or effectiveness in helping individuals quit smoking. DATA SOURCES: The authors searched PubMed, Web of Science, and additional sources for published empirical data on safety and use of electronic cigarettes as an aid to quit smoking. REVIEW METHODS: We conducted a structured search of the current literature up to and including November 2013. RESULTS: E-cigarettes currently vary widely in their contents and are sometimes inconsistent with labeling. Compared to tobacco cigarettes, available evidence suggests that e-cigarettes are often substantially lower in toxic content, cytotoxicity, associated adverse effects, and secondhand toxicity exposure. Data on the use of e-cigarettes for quitting smoking are suggestive but ultimately inconclusive. CONCLUSIONS: Clinicians are advised to be aware that the use of e-cigarettes, especially among cigarette smokers, is growing rapidly. These devices are unregulated, of unknown safety, and of uncertain benefit in quitting smoking. IMPLICATIONS FOR PRACTICE: In the absence of further data or regulation, oncologists are advised to discuss the known and unknown safety and efficacy information on e-cigarettes with interested patients and to encourage patients to first try FDA-approved pharmacotherapies for smoking cessation.

Oncology healthcare providers' implementation of the 5A's model of brief intervention for smoking cessation: patients' perceptions.

OBJECTIVE: Health care providers (HCPs) can play an important role in promoting smoking cessation and preventing relapse. Public Health Service guidelines recommend the "5A's" model of brief intervention. The goal of the current study was to examine cancer patients' perceptions of 5A's model implementation by their oncology HCPs. METHODS: This study included 81 thoracic and 87 head and neck cancer patients at a large NCI-designated comprehensive cancer center. Patients completed questionnaires assessing perceptions of their oncology HCPs' implementation of the 5A's model of brief intervention. RESULTS: Results indicate partial implementation of the 5A's model. The majority of patients reported that their providers had asked about smoking and advised them to quit, however; only half reported that their interest in quitting had been assessed, and few reported assistance in quitting or follow-up. Delivery of the 5A's was greater among patients who requested cessation advice from their HCPs. CONCLUSION: The current findings suggest a need to increase adherence to the 5A's in the oncology setting. PRACTICAL IMPLICATIONS: Efforts to increase smoking cessation treatment provision by HCPs may improve the rate of cessation among cancer patients, and ultimately translate into better long-term cancer treatment outcomes.