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RESEARCH ARTICLE (Open Access)

‘What about vaping?’ Exploring the facilitators and barriers experienced by health professionals in offering vaping cessation support − a scoping review

Lincan Caroline Tan A , Larisa Ariadne Justine Barnes B C * , Jo Longman B C and Megan Passey B C
+ Author Affiliations
- Author Affiliations

A The University of Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Science Rd, Camperdown, NSW 2020, Australia.

B The Daffodil Centre, Faculty of Medicine and Health, The University of Sydney, Level 5, 1 King St, Newtown, NSW 2042, Australia.

C University Centre for Rural Health, Faculty of Medicine and Health, The University of Sydney, 61 Uralba St, Lismore, NSW 2480, Australia.

* Correspondence to: larisa.barnes@sydney.edu.au

Public Health Research and Practice 35, PU24013 https://doi.org/10.1071/PU24013
Submitted: 4 June 2024  Accepted: 30 September 2024  Published: 9 May 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Sax Institute. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Objectives and importance of study

To summarise current evidence on the facilitators and barriers to offering vaping cessation support from the perspective of health professionals (HPs) with client-facing roles.

Study type

A scoping review following the Joanna Briggs Institute methodology.

Methods

Six databases were searched for relevant peer-reviewed articles published in English between 2003 and 2024. All articles were screened by two reviewers independently, based on pre-specified eligibility criteria. Data extraction and analyses were informed by the Theoretical Domains Framework (TDF).

Results

A total of 10,992 articles were screened; 21 publications met the inclusion criteria. Data extracted were mapped to the TDF (12 of the 14 domains were used). Barriers were more commonly reported than facilitators and included lack of knowledge, lack of training and competing priorities; the most commonly reported facilitators were HPs’ sense of responsibility and willingness to provide e-cigarette cessation support. Most of the studies included were from the US and employed quantitative surveys. Most of the studies screened focused on the utility of e-cigarettes as cessation aids for combustible tobacco smoking, highlighting a gap in the interventional evidence on e-cigarette cessation.

Conclusions

More primary qualitative studies, including in Australia, are needed to understand the complexities of offering vaping cessation support. Although a range of HPs were represented in the review, further studies could analyse allied HPs’ views separately from medical professionals’ views.

Keywords: barriers, cessation support, e-cigarettes, health professionals, public health, quitting, scoping review, Theoretical Domains Framework, vaping.

References

Jerzyński T, Stimson GV, Shapiro H, Król G. Estimation of the global number of e-cigarette users in 2020. Harm Reduct J 2021; 18(1): 109.
| Crossref | Google Scholar | PubMed |

Hess IM, Lachireddy K, Capon A. A systematic review of the health risks from passive exposure to electronic cigarette vapour. Public Health Res Pract 2016; 26(2): 2621617.
| Crossref | Google Scholar | PubMed |

Banks E, Yazidjoglou A, Brown S, Nguyen M, Martin M, Beckwith K, et al. Electronic cigarettes and health outcomes: umbrella and systematic review of the global evidence. Med J Aust 2023; 218(6): 267-75.
| Crossref | Google Scholar | PubMed |

Dyson J, Bhatnagar M, Skinner J, Crooks M. Helping the quitters quit: A systematic review and narrative synthesis of the barriers and facilitators to e-cigarette cessation and the support that is needed. Patient Educ Couns 2022; 105(6): 1402-10.
| Crossref | Google Scholar | PubMed |

Franck C, Budlovsky T, Windle SB, Filion KB, Eisenberg MJ. Electronic Cigarettes in North America: History, Use, and Implications for Smoking Cessation. Circulation (New York, NY) 2014; 129(19): 1945-52.
| Crossref | Google Scholar | PubMed |

Al-Hamdani M, Manly E. Smoking cessation or initiation: The paradox of vaping. Prev Med Rep 2021; 22: 101363.
| Crossref | Google Scholar | PubMed |

Greenhalgh E, EM B, Jenkins S, Scollo M. 18.3 Prevalence of e-cigarette use. In: Greenhalgh E, Scollo M, Winstanley M, editors. Tobacco in Australia: Facts & issues. Melbourne: Cancer Council Victoria; 2023. Available at https://www.tobaccoinaustralia.org.au/chapter-18-e-cigarettes/18-3-legal [cited 15 April 2025].

Scully M, Bain E, Koh I, Wakefield M, Durkin S. Australian secondary school students’ use of tobacco and e-cigarettes – 2022–2023. Cancer Council Victoria; 2023. Available at https://www.health.gov.au/resources/publications/australian-secondary-school-students-use-of-tobacco-and-e-cigarettes-2022-2023?language=en [cited 22 April 2025].

Yoong SL, Hall A, Leonard A, McCrabb S, Wiggers J, Tursan d’Espaignet E, et al. Prevalence of electronic nicotine delivery systems and electronic non-nicotine delivery systems in children and adolescents: a systematic review and meta-analysis. Lancet Public Health 2021; 6(9): e661-73.
| Crossref | Google Scholar | PubMed |

10  Thoonen KAHJ, Jongenelis MI. Motivators of e-cigarette use among Australian adolescents, young adults, and adults. Soc Sci Med (1982) 2024; 340: 116411.
| Crossref | Google Scholar | PubMed |

11  The Department of Health and Aged Care. Disposable vape imports now banned Australia. 2024. Available at https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/disposable-vape-imports-now-banned [cited 15 April 2025].

12  Kundu A, Seth S, Felsky D, Moraes TJ, Selby P, Chaiton M. A Systematic Review of Predictors of Vaping Cessation Among Young People. Nicotine Tob Res 2025; 27(2): 169-178.
| Crossref | Google Scholar | PubMed |

13  Department of Health and Aged Care. National Tobacco Strategy 2023–2030. Canberra: Commonwealth Department of Health and Aged Care; 2023. Available at https://www.health.gov.au/resources/publications/national-tobacco-strategy-2023-2030?language=en [cited 22 April 2025].

14  NSW Ministry of Health. Guide to Support Young People to Quit E-Cigarettes. St Leonards: NSW Ministry of Health; 2024. Available at https://www.health.nsw.gov.au/tobacco/Pages/e-cigarette-young-people-guide.aspx [cited 22 April 2025].

15  Selamoglu M, Erbas B, Kasiviswanathan K, Barton C. General practitioners’ knowledge, attitudes, beliefs and practices surrounding the prescription of e-cigarettes for smoking cessation: a mixed-methods systematic review. BMC Public Health 2022; 22(1): 2415.
| Crossref | Google Scholar | PubMed |

16  Erku DA, Gartner CE, Morphett K, Steadman KJ. Beliefs and Self-reported Practices of Health Care Professionals Regarding Electronic Nicotine Delivery Systems: A Mixed-Methods Systematic Review and Synthesis. Nicotine Tob Res 2020; 22(5): 619-29.
| Crossref | Google Scholar | PubMed |

17  Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editors. JBI Reviewer’s Manual. JBI; 2020. 10.46658/JBIMES-20-12

18  Tan CL, Passey M, Longman J, Barnes L. Exploring the Facilitators and Barriers Experienced by Health Professionals in Offering Vaping Cessation Support - A Scoping Review Proposal. Open Science Framework. 2023. 10.17605/OSF.IO/4J265

19  Atkins L, Francis J, Islam R, O’Connor D, Patey A, Ivers N, et al. A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implement Sci 2017; 12(1): 77.
| Crossref | Google Scholar | PubMed |

20  Medical Council of New Zealand. Comparable health system criteria: Medical Council of New Zealand. 2019. Available at https://www.mcnz.org.nz/registration/getting-registered/registration-policy/comparable-health-system-criteria/ [cited 26 September 2023].

21  Michie S, Atkins L, West R. The Behaviour Change Wheel: A Guide to Designing Interventions. Great Britain: Silverback Publishing; 2014.

22  Covidence systematic review software. Veritas Health Innovation Melbourne, Australia. 2024. Available at www.covidence.org [cited 15 April 2025].

23  Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008; 62(1): 107-15.
| Crossref | Google Scholar | PubMed |

24  Chin A, Zonfrillo MR, Heinly A, Ford SR, Quintos JB, Topor LS. Screening and counseling for nicotine use in youth with diabetes. Pediatr Diabetes 2022; 23(1): 157-64.
| Crossref | Google Scholar | PubMed |

25  Craig M, Tamirisa A, Madhavan R, Jochum E, Cohen A, Zoorob D. Vaping in pregnancy: A geographically focused assessment of OBGYN provider knowledge regarding the safety and usage of electronic nicotine delivery systems. Clin Exp Obstet Gynecol 2022; 49(2): 31.
| Crossref | Google Scholar |

26  Fielding-Singh P, Brown-Johnson C, Oppezzo M, Das S, Jackler R, Prochaska JJ. E-Cigarettes: Harmful or Harm-Reducing? Evaluation of a Novel Online CME Program for Health Care Providers. J Gen Intern Med 2020; 35(1): 336-40.
| Crossref | Google Scholar | PubMed |

27  Gorukanti AL, Kimminau KS, Tindle HA, Klein JD, Gorzkowski J, Kaseeska K, et al. Cross-sectional online survey of clinicians’ knowledge, attitudes and challenges to screening and counselling adolescents and young adults for substance use. BMJ Open 2022; 12(11): e059019.
| Crossref | Google Scholar | PubMed |

28  Gorzkowski JA, Whitmore RM, Kaseeska KR, Brishke JK, Klein JD. Pediatrician Knowledge, Attitudes, and Practice Related to Electronic Cigarettes. J Adolesc Health 2016; 59(1): 81-6.
| Crossref | Google Scholar | PubMed |

29  Metcalf M, Rossie K, Stokes K, Tanner B. Health Care Professionals’ Clinical Skills to Address Vaping and e-Cigarette Use by Patients: Needs and Interest Questionnaire Study. JMIR Form Res 2022; 6(4): e32242.
| Crossref | Google Scholar | PubMed |

30  Oliver AP, Bell LA, Agley J, Bixler K, Hulvershorn LA, Adams ZW. Examining the Efficacy of Project ECHO to Improve Clinicians’ Knowledge and Preparedness to Treat Adolescent Vaping. Clin Pediatr 2022; 61(12): 869-78.
| Crossref | Google Scholar | PubMed |

31  Sundstrom RM, Boyd LD, Martell KM, Vineyard J. Dental Hygienists Knowledge, Beliefs, and Intentions Regarding Asking Adolescents About Electronic Nicotine Delivery Systems Use. J Adolesc Health 2023; 73: 1053-60.
| Crossref | Google Scholar | PubMed |

32  Wilson CM, Lucado AM, Wendland DM, Taylor DWM, Black B. Health Promotion, Wellness, and Prevention Practice in Oncologic Physical Therapy: A Survey Study. Rehabil Oncol 2021; 39(3): E51-7.
| Crossref | Google Scholar |

33  Dyson J, Skinner J, Crick J, Crooks MG. Designing an intervention to help the quitters quit: A qualitative, intervention co-design study. PEC Innov 2023; 2: 100141.
| Crossref | Google Scholar | PubMed |

34  Hartwell G, Egan M, Petticrew M. Understanding decisions to use e-cigarettes or behavioural support to quit tobacco: a qualitative study of current and ex-smokers and stop smoking service staff. Addiction (Abingdon, England) 2020; 115(3): 518-26.
| Crossref | Google Scholar | PubMed |

35  Holden J, Simerson D. Screening, brief intervention and referral to treatment (SBIRT) by nurses to college students who use electronic cigarettes. J Am Coll Health 2023; 71(5): 1361-6.
| Crossref | Google Scholar | PubMed |

36  Kovach KA, Peterson R, Bharati R, Istas K, Monroe M. Co-creating opportunities to incorporate cessation for electronic nicotine delivery systems in family medicine - a qualitative program evaluation. BMC Fam Pract 2021; 22(1): 169.
| Crossref | Google Scholar | PubMed |

37  Nowlin JP, Lee JGL, Wright WG. Implementation of Recommended Tobacco Cessation Systems in Dental Practices: A Qualitative Exploration in Northeastern North Carolina. J Dent Educ 2018; 82(5): 475-82.
| Crossref | Google Scholar | PubMed |

38  Mungia R, Case K, Valerio MA, Mendoza M, Taverna M, de la Rosa EM, et al. Development of an E-Cigarettes Education and Cessation Program: A South Texas Oral Health Network Study. Health Promot Pract 2021; 22(1): 18-20.
| Crossref | Google Scholar | PubMed |

39  Cano Rodriguez Z, Chen Y, Siegel JH, Rousseau-Pierre T. Vaping: Impact of Improving Screening Questioning in Adolescent Population: A Quality Improvement Initiative. Pediatr Qual Saf 2021; 6(1): e370.
| Crossref | Google Scholar | PubMed |

40  Heinly A, Baird J, Riese A. Screening and Counseling Practices for Parental Combustible Versus Electronic Cigarette Use in Pediatric Primary Care: A Pilot Study. Clin Pediatr 2023; 62(10): 1169-75.
| Crossref | Google Scholar | PubMed |

41  Zhou SS, Baptist AP. Electronic cigarettes: How confident and effective are allergists, pulmonologists, and primary care physicians in their practice behavior? Allergy Asthma Proc 2020; 41(3): 192-7.
| Crossref | Google Scholar | PubMed |

42  McGee LU, Parker S, Bulsara S, Escobar B, Kline KN, Jibaja-Weiss ML, et al. Adolescent electronic cigarette counselling: knowledge, attitudes and perceived barriers among clinical staff in a primary care setting. J Eval Clin Pract 2021; 27(6): 1398-402.
| Crossref | Google Scholar | PubMed |

43  Longman JM, Adams CM, Johnston JJ, Passey ME. Improving implementation of the smoking cessation guidelines with pregnant women: How to support clinicians? Midwifery 2018; 58: 137-44.
| Crossref | Google Scholar | PubMed |

44  Rahman N, Sebar B, Sofija E. ‘It’s the wild west out there’: A qualitative study of the views and preparedness of health professionals in helping young adult e-cigarette users to quit. Nicotine Tob Res 2024; 26: 1538-44.
| Crossref | Google Scholar | PubMed |

45  Caltabiano P, Bailie J, Laycock A, Shea B, Dykgraaf SH, Lennox N, et al. Identifying barriers and facilitators to primary care practitioners implementing health assessments for people with intellectual disability: a Theoretical Domains Framework-informed scoping review. Implement Sci Commun 2024; 5(1): 39.
| Crossref | Google Scholar | PubMed |

46  Mungia R, Mexquitic M, Case K, Atique M, Jones B, MacCarthy D, et al. Implementation of a youth and young adult e-cigarette cessation program within a dental clinic setting: A SToHN feasibility study. Tex Dent J 2022; 139(9): 542-54.
| Google Scholar | PubMed |

47  NSW Ministry of Health. NSW clinical guidelines for the management of substance use during pregnancy, birth and the postnatal period. Sydney: NSW Ministry of Health; 2014 Available at https://www.health.nsw.gov.au/aod/professionals/Pages/substance-use-during-pregnancy-guidelines.aspx [cited 15 April 2025].

48  Russell L, Whiffen R, Chapman L, Just J, Dean E, Ugalde A, et al. Hospital staff perspectives on the provision of smoking cessation care: a qualitative description study. BMJ Open 2021; 11(5): e044489.
| Crossref | Google Scholar | PubMed |

49  Westmaas JL, Kates I, Makaroff L, Henson R. Barriers to helping patients quit smoking: Lack of knowledge about cessation methods, E-cigarettes, and why nurse practitioners and physician assistants can help. Public Health Pract 2023; 6: 100409.
| Crossref | Google Scholar | PubMed |

50  Conner M, Norman P. Understanding the intention-behavior gap: The role of intention strength. Front Psychol 2022; 13: 923464.
| Crossref | Google Scholar | PubMed |

51  Therapeutic Goods Administration (TGA). Vapes: information for pharmacists. Department of Health and Aged Care, Commonwealth of Australia; 2024. Available at https://www.tga.gov.au/products/unapproved-therapeutic-goods/vaping-hub/vapes-information-pharmacists [cited 22 April 2025].

52  Bold K, Kong G, Cavallo D, Davis D, Jackson A, Krishnan-Sarin S. School-based E-cigarette cessation programs: What do youth want? Addict Behav 2022; 125: 107167.
| Crossref | Google Scholar | PubMed |