Identifying factors that conjointly influence nicotine vaping product relative harm perception among smokers and recent ex-smokers: Findings from the 2016 ITC Four Country Smoking and Vaping Survey

Yong, Hua‐Hie; Karmakar, Chandan; Motin, Mohammod Abdul; Borland, Ron; Elton‐Marshall, Tara; Cummings, K. Michael; Fong, Geoffrey T.; Thompson, Mary E.

doi:10.1016/j.drugalcdep.2020.108370

Cited by 6 publications

(9 citation statements)

References 22 publications

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“…Second, effects were generally strongest in the United States, which had the greatest number of ‘EVALI’ cases and deaths, 1 , 5 , 6 followed by Canada, which had 20 documented cases. 5 Third, consistent with prior research, 25 , 27 , 28 youth who were exposed to negative news stories about vaping also perceived greater harms from vaping across two measures: The perception that vaping takes less than a year to harm users’ health and, among past 30-day vapers, worry that vaping will damage their health in the future. Taken together, findings suggest ‘EVALI’ may have exacerbated perceptions of vaping harms among youth internationally.…”

Section: Discussionsupporting

confidence: 63%

“…Exposure to e-cigarette advertisements has been associated with reductions in the perceived harmfulness of vaping among youth and adults, 24 , 25 while exposure to anti-vaping campaigns and news headlines can increase the perceived harmfulness of vaping among US adults. 25–27 Harm perceptions of vaping relative to smoking have also been associated with the portrayal of vaping in the media among adult smokers, 28 while providing accurate information about vaping can correct vaping misperceptions 29 and inaccurate information can increase vaping misperceptions. 30 …”

Section: Introductionmentioning

confidence: 99%

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Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)

East

Reid

Burkhalter

et al. 2022

Nicotine &Amp; Tobacco Research

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Introduction Little is known about the international impact of ‘EVALI’ on youth perceptions of vaping harms. Methods Repeat cross-sectional online surveys of youth aged 16-19 in England, Canada, and the US before (2017, 2018), during (2019Aug/Sept), and after (2020Feb/Mar, 2020Aug) the ‘EVALI’ outbreak (N=63,380). Logistic regressions assessed trends, country differences, and associations between exposure to negative news stories about vaping and vaping harm perceptions. Results Exposure to negative news stories increased between 2017 and Feb/Mar 2020 in England (12.6% to 34.2%), Canada (16.7% to 56.9%), and the US (18.0% to 64.6%), accelerating during (2019) and immediately after (Feb/Mar 2020) the outbreak (p<.001) before returning to 2019 levels by Aug 2020. Similarly, accurate perception that vaping is less harmful than smoking declined between 2017 and Feb/Mar 2020 in England (77.3% to 62.2%), Canada (66.3% to 43.3%), and the US (61.3% to 34.0%), again accelerating during and immediately after the outbreak (p<.001). Perception that vaping takes less than a year to harm users’ health and worry that vaping will damage health also doubled over this period (p≤.001). Time trends were most pronounced in the US. Exposure to negative news stories predicted perception that vaping takes less than a year to harm health (AOR=1.55, 1.48-1.61) and worry that vaping will damage health (AOR=1.32, 1.18-1.48). Conclusions Between 2017 and February/March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. Effects were seen in all countries but were most pronounced in the US. IMPLICATIONS This is the first study to examine changes in exposure to news stories about vaping, and perceptions of vaping harms, among youth in England, Canada, and the US before, during, and after ‘EVALI’. Between 2017 and February/March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained. Exposure to negative news stories also predicted two of three harm perceptions measures. Overall, findings suggest ‘EVALI’ may have exacerbated youth’s perceptions of vaping harms internationally.

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Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)

East

Reid

Burkhalter

et al. 2022

Nicotine &Amp; Tobacco Research

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“…Our finding of a predictive relationship between NVP/NRT harm perceptions and their use has important implications as it suggests that use of these products for smoking cessation could be undermined by misperceptions of their harmfulness. Past research suggests that potential sources of harm misperceptions of nicotine-containing products include inaccurate beliefs about the links between nicotine and cancer, 13 exposure to misinformation from social media, government websites and tobacco industry, 25 , 40 and interpreting uncertainty about the long-term health effects of product use as indicator of significant unknown risks. 41 Given that NRT and NVPs are the two most popular smoking cessation aids, 5 and that there was still a substantial number of smokers who remain either misinformed or unaware of the relative harmfulness of NRT and NVPs compared to cigarettes, education and accurate messaging around the harms of these nicotine products is needed.…”

Section: Discussionmentioning

confidence: 99%

“… 13 This may account for the high correlation found between harm perceptions of NRT and NVPs. 25 Regardless of the mechanisms, harm perceptions are likely to generalize across all nicotine products, rather than be product specific. This cross-product relationship between harm perceptions of one nicotine product (eg, NRT) and use of other nicotine products (eg, NVPs), particularly for the purpose of smoking cessation, has not been studied before.…”

Section: Introductionmentioning

confidence: 99%

Do Smokers’ Perceptions of the Harmfulness of Nicotine Replacement Therapy and Nicotine Vaping Products as Compared to Cigarettes Influence Their Use as an Aid for Smoking Cessation? Findings from the ITC Four Country Smoking and Vaping Surveys

Yong

Gravely

Borland

et al. 2022

Nicotine &Amp; Tobacco Research

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Aim This study examined whether smokers’ harm perceptions of nicotine replacement therapy (NRT) and nicotine vaping products (NVPs) relative to cigarettes predicted their subsequent use as smoking cessation aids during their last quit attempt (LQA). Methods We analyzed data from 1,315 current daily smokers (10+ cigarettes per day) who were recruited at Wave 1 (2016), and who reported making a quit attempt by Wave 2 (2018) of the International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England, and the US. We used multinomial logistic regression models to examine prospective associations between harm perceptions of a) NRT and b) NVPs and their use at LQA, controlling for socio-demographic and other potential confounders. Results Smokers who perceive that a) NRT and b) NVPs are much less harmful than cigarettes were more likely to subsequently use the respective product as an aid than using no aid or other aids during LQA (adjusted relative risk ratio [aRRR]=3.79, 95%CI=2.16-6.66; and aRRR=2.11, 95%CI=1.29-3.45, respectively) compared to smokers who perceive these products as equally or more harmful. Additionally, those who perceive NVPs as much less harmful than cigarettes were less likely to use NRT as a quit aid (aRRR=0.34, 95%CI=0.20-0.60). No country variations for these associations were found. Conclusion This study found that smokers’ perceptions of the harmfulness of a) NRT and b) NVPs relative to cigarettes predicted the respective product use when trying to quit smoking. Corrective education targeting misperceptions of nicotine products’ relative harmfulness may facilitate their use for smoking cessation. IMPLICATIONS What this study adds:Nicotine replacement therapy and nicotine vaping products are two commonly used smoking cessation aids. This study demonstrates that misperceptions of the harms of nicotine products relative to cigarettes influence their use for smoking cessation. Believing that nicotine vaping products are much less harmful than cigarette smoking may lead some smokers to prefer these products over nicotine replacement therapy to aid smoking cessation. Education targeting misperceptions of nicotine products’ harmfulness relative to cigarettes may enable smokers to make informed choices about which are appropriate to aid smoking cessation.

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“…We were also not able to account for passive exposure to information about e-cigarettes (e.g. from news sources, advertising) because the survey did not include such items; it is, then, unclear how such exposure might have affected our measures [41].…”

Section: Limitationsmentioning

confidence: 99%

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

Ileş

Gillman

Klein

et al. 2021

Drug and Alcohol Review

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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.

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Identifying factors that conjointly influence nicotine vaping product relative harm perception among smokers and recent ex-smokers: Findings from the 2016 ITC Four Country Smoking and Vaping Survey

Cited by 6 publications

References 22 publications

Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)

Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)

Do Smokers’ Perceptions of the Harmfulness of Nicotine Replacement Therapy and Nicotine Vaping Products as Compared to Cigarettes Influence Their Use as an Aid for Smoking Cessation? Findings from the ITC Four Country Smoking and Vaping Surveys

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

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