An Original Survey Assessing E-Cigarette Regulation and Perceptions in all North Carolina Hospitals: A Research Design Proposal
Creators: name: Dunlap, Daniel
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2014

description: Abstract Introduction: E-cigarettes are devices that heat a liquid solution, typically containing nicotine, to generate a vapor and simulate the act of smoking. Since first marketed in 2004 as a potential smoking cessation tool, use has become increasingly controversial, as data on safety and efficacy are limited. A movement toward establishing tobacco-free campuses has emerged among U.S. hospitals, but the extent to which e-cigarettes have been included in such policies has not been systematically researched. This master's paper offers a research design proposal for an online survey containing questions on tobacco and e-cigarette policy and perceptions which would be distributed to administrators in all North Carolina Hospitals. Background: The literature on e-cigarettes is quickly expanding, but is still markedly limited. In lieu of federal regulatory policy, many states, such as North Carolina, have adopted their own policies, most commonly to prohibit the sale of e-cigarettes to minors. In April, 2014, the FDA declared its intent to make e-cigarettes subject to a series of stronger regulations; however, the proposed regulatory activity may not take effect for several years, if at all. On local levels, some hospitals, workplaces, and schools are beginning to include electronic cigarettes in tobacco-free campus policies, but the pervasiveness of this trend has not been systematically researched. Purpose: This survey will examine what percentage of hospitals in N.C. have created policy regulating the use of electronic cigarettes on campus, where e-cigarette use is prohibited for those hospitals with existing policy (e.g. indoors only, indoors and on grounds), and which factors are motivators for and barriers to the creation of policy regulating use of e-cigarettes. Methods: A 30-item online questionnaire that will be distributed via e-mail to administrators in all N.C. hospitals by the North Carolina Hospital Association in July-August, 2014. The survey contains questions on hospital tobacco policies and e-cigarette policies, motivators for and barriers to e-cigarette policy development, perceptions of e-cigarette safety, and how policies are communicated by hospital administration to hospital staff, patients, and visitors. Anticipated Findings: We hypothesize that despite the tobacco-free campuses established by all N.C. hospitals, a majority of hospitals have not yet included any regulations prohibiting the use of electronic cigarettes on campus. A secondary hypothesis is that hospitals with stronger tobacco use treatment programs will have advanced regulations on the use of e-cigarettes more than those without strong treatment programs. Discussion and Conclusions: Literature on e-cigarettes as a smoking cessation tool is limited, and federal regulation has been in a state of flux for several years. The FDA has recently called for a much stricter set of regulations for e-cigarettes, but NC hospitals would presumably not be affected for several years. Our results offer the opportunity for NC hospitals to work toward establishing uniform guidelines for e-cigarette regulation by learning for the experiences of peers, and may also be of value to public health stakeholders at multiple levels.