P1050 - Lost in the haze: Knowledge and practice gaps for vaping versus tobacco smoke exposure.

Introduction:
E-cigarette use, or vaping is epidemic in adolescents. Twenty percent of high school and 5% of middle school students reported vaping use. The CDC has reported more than 2700 hospitalized cases and 60 deaths linked to vaping. Vaping related illness presents with respiratory or non-respiratory symptoms and the history is not easily offered by teenagers.

Objectives:

-Measure the knowledge gaps and practice differences toward vaping versus tobacco smoke exposure.
- Assess confidence, perceived barriers, and knowledge stratified by level of medical training.

Methods:
We performed a literature search and identified one TSE screening tool. We adapted the tool, added vaping questions, and revised the tool with input from survey experts and content experts affiliated with the AAP Section on Tobacco Control. We performed cognitive interviews with residents to ensure question clarity and construct validity. The final tool consisted of 24 questions assessing demographics, screening and intervention practices for TSE and vaping, and barriers to and confidence in providing interventions. Knowledge of e-cigarette nicotine content, nomenclature, and AAP recommendations was assessed. The survey was administered anonymously through REDCap to pediatric residents and fellows, and pediatricians including outpatient providers, hem-onc, pulmonary and infectious disease subspecialists.

Results:
The response rate was 60% (43/72) with 69% (27/39) learners responding and 48% (16/33) non-learners responding (p = 0.07). Comparison of TSE and vaping screening and interventions are shown in table 1. Figure 1 shows counseling confidence stratified by learner status and cessation training. Most (85%) respondents were unaware of the prevalence of vaping among teenagers. Thirty five percent of respondents were unfamiliar with JUUL (most popular youth vape device). Only 40% were aware that most teenagers (60%) believe JUUL contains no nicotine.
Learners reported lack of knowledge and resources for addressing positive screens as the main perceived barriers to screening and intervention, while non-learners endorsed lack of time.

Discussion/

Conclusion:
We identified less screening for vaping compared with TSE, knowledge gaps, and limited screening during non-respiratory illness despite myriad vaping presentations. We have used these data to inform a quality improvement project aimed at increasing screening and intervention rates.