Changing Perceptions of Harm of E-Cigarettes Among U.S. Adults, 2012–2015

Abstract

Introduction Although the impact of long-term use of electronic cigarettes (e-cigarettes) on health is still unknown, current scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes. The study examined whether perceived relative harm of e-cigarettes and perceived addictiveness have changed during 2012–2015 among U.S. adults. Methods Data were from Tobacco Products and Risk Perceptions surveys of probability samples representative of U.S. adults in 2012, 2014, and 2015. Changes over time in perceived harmfulness of e-cigarettes were examined using pairwise comparisons of proportions and multinomial logistic regression analysis. Analyses were conducted in January 2016. Results Whereas 11.5% and 1.3% of adults perceived e-cigarettes to have about the same level of harm and to be more harmful than cigarettes, respectively, in 2012, 35.7% and 4.1% did so in 2015. The proportion of adults who thought e-cigarettes were addictive more than doubled during 2012–2015 (32.0% in 2012 vs 67.6% in 2015). Compared with 2012, the odds of perceiving e-cigarettes to be equally or more harmful (than to be less harmful) doubled (95% CI=1.64, 2.41) in 2014, and tripled (95% CI=2.60, 3.81) in 2015. Conclusions There is an increase in the proportion of U.S. adults who misperceive the harm of e-cigarettes and consider them to be as harmful as combustible cigarettes. The study highlights the need to design public health messages that accurately interpret the scientific data on the potential harm of e-cigarettes and clearly differentiate the absolute from the relative harm of e-cigarettes.

Trends in Awareness, Use of, and Beliefs About Electronic Cigarette and Snus Among a Longitudinal Cohort of US Midwest Young Adults

“…Another US national study found that in 2015, 45.5% of 18-24 year-olds and 36.8% of 25-34 year-olds believed that e-cigarettes are less harmful than cigarettes. 40 These estimates are higher than those we estimated in 2012-2013. We did not identify recent national data on snus use and perceptions.…”

To vape or not to vape? Effects of exposure to conflicting news headlines on beliefs about harms and benefits of electronic cigarette use: Results from a randomized controlled experiment

“…Specifically, we offer new empirical evidence to support the hypothesis that exposure to conflicting information could be related to observed trends in public knowledge and greater perceived harms associated with e-cigarette use over time. 14,15 This analysis further adds to the growing body of research establishing associations between exposure to conflicting information and cognitions or behavior in other health domains (e.g., nutrition, HPV vaccination). 7,10 Future research could explore other outcomes of exposure to conflicting e-cigarette information, which have been explored in other health domains, including public perceptions of uncertainty or confusion about e-cigarettes, perceived trust and credibility of science/health recommendations, and tobacco use behaviors.…”

“…13 Conflicting information exposure may lead to confusion and lower perceived harms toward e-cigarette use, and these in turn may reduce support for regulating e-cigarettes. 13 Although recent articles have implicated conflicting information in shaping public knowledge and perceptions of e-cigarettes, 14,15 it is not known whether exposure to conflicting information about e-cigarettes does in fact influence beliefs about e-cigarette harms and benefits.…”

Do Emotions Spark Interest in Alternative Tobacco Products?

“…The same visceral response has not been seen in regards to electronic cigarettes, which are frequently viewed as modern and trendy (McDonald & Ling, 2015; Wagoner et al, 2016). In contrast, anxiety might be more pertinent to e-cigarettes where consumers are frequently uncertain about the health effects and unknown risks of these novel products (Majeed et al, in press). …”