Background/objectives In the UK there are now more than two million users and more than 400 variations on electronic cigarettes (e-cigarettes) based on nicotine strength, flavours, devices etc. Despite the exponential rise in the use of e-cigarettes primarily as an adjunct to quit smoking strategies, the drive has predominantly been patient led and industry marketed with medical profession reluctant to engage, citing potential toxic effects as yet uncertain. Reporting from semi-rural community and focusing on respiratory patients attending respiratory clinics, objectives were to (1) document the current smoking pattern of our patients, (2) investigate their prior health seeking behaviour with respect to quit smoking, and (3) more specifically with respect to e-cigarettes address some of the questions raised with respect to where the medical profession may still have a role.

Methods Prospective, self-completed, questionnaire based survey of patients (>75%) attending respiratory clinic first three weeks July 2014,

Results Of 78 patients, mean ((range) age was 63 (17–91) years with 49% male. Of these, 17 were smokers, 32 ex-smokers, and 29 never smokers. 42/49 (86%) had previously attempted to quit smoking; 26/42 had used no outside support, two had used nicotine gum or patches, three used drug therapies including Zyban or Champix, seven had used a combination, and four had used other unspecified techniques. 11/49 (22.4%) of those who had ever smoked had tried e-cigarettes: average set up was £23.33 with purchase on-line for three, specialist shops for four, market stalls for two, supermarket for one, and for one patient it was a gift. Only one patient had prior concerns about harmful effects, with two others asking and two others specifically being told by their retailer. Similarly, only two were given advice about suitable dosing based on baseline nicotine use, and two others about how to plan use and weaning.

Conclusions Although based on a small number of patients, the high use of e-cigarettes is recognised as is the intention to quit smoking. Importantly, the survey identifies a need for patient education about use and potential for harm and it is important that we now actively engage.