• Pietro Ferrara, Saran Shantikumar, Vítor Cabral Veríssimo, Rafael Ruiz-Montero, Cristina Masuet-Aumatell, Josep Maria Ramon-Torrell, and EuroNet MRPH Working Group on Electronic Cigarettes and Tobacco Harm Reduction.
• Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy. pietro.ferrara1@unicampania.it.
• Int J Environ Res Public Health. 2019 Jun 12; 16 (12).

IntroductionAlthough electronic cigarettes (e-cigarettes) and other tobacco-related products are becoming widely popular as alternatives to tobacco, little has been published on the knowledge of healthcare workers about their use. Thus, the aim of this study was to elicit the current knowledge and perceptions about e-cigarettes and tobacco harm reduction (THR) among medical residents in public health (MRPH).Material And MethodsA Europe-wide cross-sectional study was carried out amongst MRPH from the countries associated with the European Network of MRPH from April to October 2018 using an online questionnaire.Results256 MRPHs agreed to participate in the survey. Approximately half the participants were women (57.4%), with a median age of 30 years, and were mainly Italian (26.7%), Spanish (16.9%) and Portuguese (16.5%). Smoking prevalence was 12.9%. Overall, risk scores significantly differed for each investigated smoking product when compared with e-cigarettes; with tobacco cigarettes and snus perceived as more risky, and nicotine replacement therapy (NRT) and non-NRT oral medications seen as less risky (p < 0.01 for all). Regarding the effects of nicotine on health, the vast majority of MRPHs associated nicotine with all smoking-related diseases. Knowledge of THR was low throughout the whole sample.ConclusionsEuropean MRPH showed a suboptimal level of knowledge about e-cigarettes and THR. Training programs for public health and preventive medicine trainees should address this gap.

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