Associations between absolute and relative electronic cigarette harm perceptions and information‐seeking behaviours among US adult current, former and never smokers

Abstract

Introduction. Electronic cigarette (e-cigarette) harm perceptions and information seeking behaviours are both important antecedents of e-cigarette use, yet the relationship between them has been rarely studied. We assessed how absolute (e-cigarettes are harmful to my health) and relative harm perceptions (e-cigarettes are more/less harmful than cigarettes) were associated with specific e-cigarette information seeking behaviours in a sample of current, former and never cigarette smokers. Methods. We used data from US adults in two cycles of the Health Information National Trends Survey (HINTS-FDA 2015, n = 3738; 2017, n = 1736). Analyses controlled for socio-demographics, ever e-cigarette use and survey cycle. Data were analysed between January and August 2020. Results. Higher relative harm perceptions were associated with lower odds of having sought any information on e-cigarettes [adjusted odds ratio 0.61, 95% confidence interval (0.48, 0.84)] and on how to use e-cigarettes to quit smoking specifically [adjusted odds ratio 0.59, 95% confidence interval (0.38, 0.91)]. Smoking status did not moderate associations between absolute or relative harm perceptions and information seeking behaviours, nor was it associated with specific information seeking behaviours after adjusting for covariates. Discussion and Conclusions. The risks of e-cigarettes relative to combusted cigarettes (as opposed to the absolute risks of e-cigarettes) appear to be more important in individuals' information seeking behaviours about e-cigarettes. Public health messages could ensure that all individuals understand how one's health risk would change if they exclusively used e-cigarettes, switched to e-cigarettes completely or used both products. [Iles IA, Gillman AS, Klein WMP, Ferrer RA, Kaufman A. Associations between absolute and relative electronic cigarette harm perceptions and information-seeking behaviours among US adult current, former and never smokers.

How do Risk Perceptions Drive Smokers to Completely Switch to a Smoke-Free Tobacco Product (IQOS ™)? A Four-Country Cohort Study

“…As opposed to absolute harm messages, relative messages have been shown to be more effective in reducing harm perceptions and increasing use intentions of smoke-free TPs among smokers (8). Similarly, relative harm perceptions seem to be more important to individuals' TP information-seeking behaviors (39) and are associated with smoking onset and cessation (37) as well as switching to smoke-free TPs (17)(18)29). This suggests that people consider the health risk of TP use in terms of relative harm (37), so that tobacco control policy, regulation, and the content of public health messages should be informed by relative harm perceptions (39).…”

“…Similarly, relative harm perceptions seem to be more important to individuals' TP information-seeking behaviors (39) and are associated with smoking onset and cessation (37) as well as switching to smoke-free TPs (17)(18)29). This suggests that people consider the health risk of TP use in terms of relative harm (37), so that tobacco control policy, regulation, and the content of public health messages should be informed by relative harm perceptions (39). Depending on the country, in the present study the reasons that could be indicated for using IQOS™ included either both RF and RH reasons, or an RF or RH reason alone.…”

“…Eventually, public understanding has to be aligned with the general conclusions of authoritative sources, i.e., that smoke-free TPs are generally less harmful than combustible TPs (29,38). Moreover, public health messages should help consumers understand how their individual health risk would change if a smokefree TP is used only partially or exclusively (39). Finally, in the present study, the results of A-3 revealed that perception of IQOS™' RF and/or RH increased the likelihood of stable exclusive IQOS™ use by up to 1.…”

“…Depending on the country, IQOS™ users who indicated RF and/or RH as a reason for using IQOS™ were 1.4-2.3 times more likely to report being exclusive IQOS™ users at week 48 than those who did not indicate RF and/or RH (odds ratio (OR) [95% confidence interval (CI)]: Japan, 1. 39 16-2.43]). The additional sensitivity analysis for 60 and 72 weeks of follow-up revealed similar ORs to those in the 48-week follow-up.…”