U.S. adults' addiction and harm beliefs about nicotine and low nicotine cigarettes

Abstract

This research described U.S. adults' beliefs about nicotine and low nicotine cigarettes (LNCs) using the nationally-representative Health Information National Trends Survey (HINTS-FDA 2015; N = 3738). About three quarters of people either were unsure of the relationship between nicotine and cancer or incorrectly believed that nicotine causes cancer. People who were non-White, less educated, age 65+, and never established smokers were most likely to be unaware that nicotine is not a cause of cancer. More than a quarter of people held the potentially inaccurate beliefs that LNCs would be less harmful and addictive than typical cigarettes. Whites were more likely than Blacks to believe LNCs were less harmful than typical cigarettes, and never smokers were more likely to believe this than established quitters. Whites and people with at least a college degree were more likely to believe that LNCs would be less addictive than typical cigarettes. Overall, we found that many people, particularly the demographic subgroups identified here, held incorrect beliefs about nicotine and potentially inaccurate beliefs about LNCs. Findings should be considered in assessing the public health impact of marketing low nicotine products. Incorrectly believing that nicotine causes cancer could discourage smokers from switching to safer nicotine-containing alternatives, and could lead nonsmokers to experiment with low nicotine tobacco products, believing that cancer risk would be reduced. Findings underscore the need to educate the public on the health effects of nicotine and LNCs, and can help public health practitioners determine which subgroups should be prioritized in targeted educational efforts.

Effects of immediate versus gradual nicotine reduction in cigarettes on biomarkers of biological effects

“…If nicotine in cigarettes were to become regulated, it would be imperative to educate the consumer that this product standard is not associated with a significant reduction in cigarette harm. Smokers tend to report misperceptions of the harms of cigarettes that are significantly reduced in levels of nicotine . These misperceptions are due largely to the erroneous belief that nicotine causes cancer or heart disease and, therefore, if nicotine is reduced in a product, then it would be safer.…”

Effects of a Nicotine Fact Sheet on Perceived Risk of Nicotine and E-Cigarettes and Intentions to Seek Information About and Use E-Cigarettes

“…Key measures are shown in Table 1. Outcome variables included perceived addictiveness of nicotine and perceived risk of nicotine [5], perceived e-cigarette risk (absolute [14,15] and comparative [15,16]), and behavioral intentions (intentions to switch to e-cigarettes [15], e-cigarette and cigarette dual use intentions [15], and intentions to seek information about e-cigarettes [17][18][19][20]). Covariates included gender, age, race, education, daily vs. non-daily smoking, use of e-cigarettes (current vs. former vs. never use), quit attempt in the past 12 months, smoking identity [21], and pre-exposure perceived comparative risk of e-cigarettes, perceived addictiveness of nicotine, and perceived risk of nicotine.…”

“…Nicotine is the main addictive ingredient in cigarettes, but it is not the major cause of smoking-related death and disease [3]. However, people often hold the opposite belief [4,5]. In 2016, 80% of U.S. adults thought nicotine was the main cause of disease from tobacco products [4].…”

“…In 2016, 80% of U.S. adults thought nicotine was the main cause of disease from tobacco products [4]. This misperception may mislead people into believing that low nicotine cigarettes are less harmful than current cigarettes and prevent smokers from using evidence-based smoking cessation aids [5,6] or from switching to potentially less harmful tobacco products [4,[6][7][8]. These issues might be prevented by educating the public about nicotine [9].…”

Examining Risk Perceptions Among Daily Smokers Naïve to Reduced Nicotine Content Cigarettes

“…Extant research suggests that smokers hold misperceptions about the risks of using RNC cigarettes. 6,16,17 These studies, however, have assessed perceptions following exposure to these products, 6,16 which may not represent perceptions before policy implementation, or have been limited to assess only one or two beliefs (eg, cancer risk 17 ; addictiveness, harmfulness 18 ). Thus, our data extend this literature by examining multiple risk perceptions among an RNC-naïve sample.…”