A recently released survey reveals that a vast majority of doctors worldwide mistakenly believe nicotine causes lung cancer and other diseases. It’s a common misperception that may impede efforts to help people quit smoking by using tobacco harm reduction products.
The survey, funded by the Foundation for a Smoke-Free World, found that nearly 77% of doctors believe nicotine causes lung cancer, as well as other smoking-related diseases. Decades of research have shown this is not the case, but the belief persists among many healthcare professionals. The concern is that it may prevent them from recommending their patients use nicotine replacement therapy (NRT) products such as gums, vape pens and patches to kick the smoking habit.
“It is imperative that doctors get the proper training to learn the facts about nicotine and tobacco harm reduction options that can help their smoking patients quit,” Dr. Muhammad Ahmed, Director of Health and Science Research, Foundation for a Smoke-Free World, said in a news release. “With more than 7 million smokers dying annually from smoking-related diseases worldwide, many lives can be saved if doctors become more knowledgeable about the cessation tools available.”
More than 15,000 Doctors Surveyed in 11 Countries
Researchers with Sermo conducted the survey, which was funded by a grant from the Foundation for a Smoke-Free World. Sermo is an online community that connects more than 1.3 million healthcare professionals in 150 countries, allowing them the opportunity to communicate and share knowledge about health-related issues. The survey aligns with the Foundation’s mission to end smoking in this generation. The nonprofit supports health and science research, agricultural diversification, and industry transformation to end smoking-related death and disease.
For the survey, Sermo spoke with more than 15,000 doctors in China, Germany, Greece, India, Indonesia, Israel, Italy, Japan, South Africa, United Kingdom, and the United States. An average of 87% of the doctors ranked helping patients quit smoking as a priority, but nearly 77% wrongly believe nicotine causes lung cancer and 78% believe it causes atherosclerosis.
Doctors’ Incorrect Views on Nicotine Consistent Worldwide
The survey consistently found misperceptions about nicotine in every country and involving a variety of diseases. For example, nearly 74% of all doctors on average at least moderately agree that nicotine causes lung, bladder, and head/neck/gastric cancer. In the United States, 70% of doctors said they believe this, with somewhat higher numbers in Germany (78%), China (86%), and Japan (85%).
Worldwide, 78% of doctors on average at least moderately agree that nicotine causes atherosclerosis, a disease of the arteries involving deposits of fatty material on the arterial walls. Also, 76% of doctors worldwide on average believe nicotine causes chronic obstructive pulmonary disease (COPD). However, the survey also featured some responses from doctors that showed a willingness to learn more about cessation and tobacco harm reduction options.
Cessation and Tobacco Harm Reduction
Among the more than 15,000 physicians who responded to the survey, a majority showed an interest in the use of cessation and tobacco harm reduction products, with more than 80% expressing that they are at least moderately interested in getting training in these areas.
As noted by the International Agency for Research on Cancer (IARC), a specialized cancer agency of the World Health Organization (WHO), NRT products have been on the WHO list of essential medicines since 2009. The IARC writes that these products “can gradually replace the need for nicotine in cigarette smokers while minimizing the exposure of users to the carcinogens and other toxic substances in tobacco smoke. Medicinal nicotine is therefore a safer alternative to tobacco products.”
The nonprofit Cancer Research UK echoes this assessment, writing on its website that nicotine is “not responsible for the harmful effects of smoking, and nicotine does not cause cancer.” The organization adds that “people have safely used” NRTs to stop smoking for many years.
However, the Sermo survey results showed that NRTs are often not discussed with patients, despite their proven ability to help people reduce smoking. Among the doctors who participated in the poll, 73% (on average, globally) said conversations with patients who smoke focus on the health benefits they can realize by cutting down or quitting smoking. An equal percentage said they focus these conversations on the potential health risks for those who continue smoking. However, a far lesser number (56% on average, globally) said they recommend cutting down on the amount of smokable tobacco products and even less (48% on average, globally) said they help patients develop a quitting plan.
The Foundation for a Smoke-Free World is asking researchers to submit proposals, including for investigator-initiated studies, that examine the survey’s findings and propose analysis or programs that address further opportunities.
Importance of Cessation and Tobacco Harm Reduction Products
The results of the Sermo survey show the challenges faced to eliminate the barriers that keep smokers from switching from combustible and other harmful tobacco products to NRTs, as well as the potential opportunities.
The survey also aligns with the Foundation’s Strategic Plan goal to “strengthen understanding, knowledge, and research capacity in the area of tobacco harm reduction and its role to end smoking.” The willingness of doctors to receive additional training on tobacco harm reduction products is a hopeful sign in this key area.
The Foundation also focuses on steps taken by the largest companies in the global tobacco industry to promote the use of harm reduction products. The Tobacco Transformation Index, a Foundation initiative, ranks the world’s largest tobacco companies on their relative progress toward reduction of the harm to global public health caused by use of tobacco products.
