# Knowledge and perceptions of nicotine, smoking cessation and electronic nicotine delivery systems among physicians and pharmacists in a Swiss hospital group

## TL;DR

This study finds that Swiss healthcare professionals have mixed knowledge about nicotine and e-cigarettes, with gaps in understanding newer smoking cessation tools.

## Contribution

The study is the first to assess nicotine and e-cigarette knowledge among Swiss healthcare professionals, revealing specific misperceptions and knowledge gaps.

## Key findings

- Most participants correctly identified nicotine as the addictive substance in tobacco.
- A majority opposed recommending e-cigarettes for smoking cessation despite acknowledging they are less harmful than combustible cigarettes.
- Participants expressed uncertainty about the public health impact of e-cigarettes compared to traditional cigarettes.

## Abstract

Despite the important role that healthcare professionals play in smoking cessation strategies, recent reports from several countries show misperceptions about nicotine, pharmacotherapy for smoking cessation and novel nicotine products, but little is known about such knowledge gaps among healthcare professionals in Switzerland.

This study involved a cross-sectional anonymous survey. Physicians and pharmacists from a large hospital group in Switzerland were invited in 2023 by e-mail to participate. The survey covered nicotine, smoking cessation, and knowledge of electronic nicotine delivery systems (ENDS).

Of the 2035 healthcare professionals contacted, 279 responded to the survey (14%). Fifty-three percent of participants identified as women, 69% were in the age group of ≤40 years, 77% were never smokers, and 85% saw patients daily. The majority (76%) agreed that nicotine is the main substance in tobacco responsible for addiction, while 73% and 69% disagreed that nicotine on its own causes cancer or chronic obstructive pulmonary disease (COPD), respectively. Most participants (n=128; 63%) opposed the recommendation of e-cigarettes as a smoking cessation aid, although e-cigarettes were considered less harmful than combustible cigarettes, both for users and bystanders. Nevertheless, 64% considered them to be equally or more problematic for public health than tobacco cigarettes.

This survey highlights knowledge gaps and misperceptions about nicotine and smoking cessation products among healthcare professionals in a large hospital group in Switzerland. Respondents appeared to have a relative accurate understanding regarding most of the direct effects of nicotine. However, uncertainties were noted in relation to newer products such as e-cigarettes. Future research should extend to other healthcare professionals and assess the impact of targeted training on knowledge and clinical practice.