E-cigarette knowledge of undergraduate pharmacy students
Authors: Audi H , Swithenbank Z , McCloskey A , Hay G 
Published: April 2024

Abstract

Introduction
The use of e-cigarettes (known as vaping) is creating public health opportunities and challenges. E-cigarettes are effective as a smoking cessation tool. However, they are not without risk. E-cigarettes are relevant to pharmacists as they can provide advice about smoking cessation and they are well placed to provide more generic support and information about e-cigarettes, including side effects.
Notifications about any issues with e-cigarettes can be done through the United Kingdom’s (UK’s) Medicines and Healthcare products Regulatory Agency (MHRA) Yellow Card Scheme. Vaping products can be considered as licensed, but not yet prescribed within the UK National Health Service (NHS). There are benefits in pharmacists being knowledgeable about the legal and regulatory status of e-cigarettes.
It is currently unclear whether pharmacy students are knowledgeable about e-cigarettes and their role in smoking cessation. It is also unclear whether they are aware of the relevance to the Yellow Card scheme.

Aim
To examine e-cigarette knowledge of undergraduate pharmacy students studying at a large university in the northwest of England, some of which may be concurrently working within retail pharmacy.

Methods
A link to an online quantitative survey was distributed to all students (approximately 500) studying on the four-year undergraduate pharmacy (MPharm) programme by the programme leader. This was done by email in April 2023. The research was carried out as part of a public health student’s dissertation with a questionnaire designed and piloted by the student. Results were mainly descriptive and χ2 tests were carried out using SPSS where appropriate.

Results
A convenience sample of 55 students (approximately 10%) was achieved. Just over half the respondents stated they did not know if e-cigarettes were available on prescription or from the NHS. Only 12% of respondents knew that e-cigarettes were regulated for safety and quality in the UK, with 50% of all respondents stating that they were not. Just over half (58%, n=32) did not know whether medically licensed e-cigarettes were available. Less than 10% of all respondents (n=5) were aware that e-cigarettes users can report via Yellow Card Scheme if suspecting a side effect from using e-cigarettes. Interestingly, 46% of those currently working in retail pharmacy (n=11) wrongly stated “no” when asked about the Yellow Card Scheme. This compared to 19% (n=6) of those not currently working in retail settings (χ2=4.44, df=1, p=0.035), indicating that those with current retail experience were less knowledgeable about the Yellow Card Scheme in relation to e-cigarettes. All respondents agreed that pharmacists should be providing health-related advice on vaping to their clients/patients.

Conclusion
There may be merit in including relevant material on e-cigarettes, including the licensing and Yellow Card scheme, along with more general information on the benefits of switching from cigarettes to vaping and the need to stop vaping, within undergraduate programmes. A strength of this study was that it was one of the first that looked at knowledge of the Yellow Card scheme among pharmacy students, but a main weakness was that it was a small, self-selecting sample of students.