Physicians' Knowledge Level, Sources of Information, and Clinical Smoking Cessation Practices Regarding Electronic Cigarettes: A Cross-sectional Study in Adana, Türkiye.

Abstract

Objective: Data on physicians' knowledge and clinical practices regarding electronic cigarettes (e-cigarettes) remain limited, particularly among physicians from diverse specialties within the same setting. This study assessed the knowledge level, information sources, and smoking cessation counseling practices regarding e-cigarettes of physicians in Adana province and examined associations with sociodemographic and occupational characteristics.

Material and methods: A cross-sectional survey was conducted among 525 physicians in Adana between January 26 and February 16, 2026, using a 12-item e-cigarette knowledge scale (0-12) and a 5-item smoking cessation counseling practice scale (5-25). Between-group comparisons were performed using the Mann-Whitney U and Kruskal-Wallis tests; associations were assessed using Spearman's correlation; independent predictors of practice score were identified using multivariate linear regression.

Results: Mean knowledge score was 9.40±2.75 [95% confidence interval (CI): 9.17-9.64] and mean practice score was 20.71±4.07 (95% CI: 20.36-21.06). Knowledge and practice scores were not correlated (ρ = 0.063; 95% CI: -0.022-0.148; P = 0.148). Practice score was associated with specialty, professional title, institution, age, and chronic disease (all P < 0.05). In multivariate regression, age, specialty, and physicians' own tobacco/nicotine use remained independent predictors (B = -0.739; P = 0.041 for tobacco/nicotine users). Social media were the most frequently reported information sources (40.2%; 95% CI: 36.1-44.4%).

Conclusion: Physicians' e-cigarette knowledge was moderate to high, but was not associated with general smoking cessation counseling practices, which were not assessed as e-cigarette-specific. Educational interventions should incorporate structured clinical protocols in addition to knowledge transfer.