Study shows increase in perceived harm of electronic cigarettes among U.S. adults

The number of U.S. adults who perceive e-cigarettes to be at as harmful as, or more harmful than, cigarettes has increased between 2017 and 2018, even prior to the national outbreak of vaping-related lung disease and deaths, a study by tobacco researchers from Georgia State University's School of Public Health has found.

The findings, published in JAMA Network Open, augment earlier work by the researchers that found an increase in perceived harm of e-cigarettes relative to cigarettes between 2012 and 2017.

The percentage of adults who perceived e-cigarettes to be less harmful than cigarettes decreased from 29 percent in 2017 to 26 percent in 2018, while the proportion of adults who perceived e-cigarettes to be equally harmful, more harmful, or much more harmful than cigarettes all increased in that time.

In 2018, 43 percent of U.S. adults considered e-cigarettes to be as harmful as cigarettes and 8 percent considered e-cigarettes to be more harmful or much more harmful than cigarettes. This trend was also observed among current smokers of cigarettes, a finding that has implications for smokers' decision-making around switching to e-cigarettes.

Smokers who perceive too much risk from e-cigarettes may decide against using them to quit smoking and may instead continue with their combustible smoking habit. The increase in perceived harm of electronic cigarettes may reflect growing concerns about the surge in e-cigarette use among young people, and the subsequent media coverage of the teen vaping epidemic."

Amy L. Nyman, lead author of the study and research associate in the School of Public Health

Nyman noted that perceived harm of e-cigarettes relative to cigarettes may have increased further since 2018 because of the recent outbreak of vaping-related illnesses, which have resulted in at least 42 deaths nationwide, according to the Centers for Disease Control and Prevention.

The study used data from The Tobacco Products and Risk Perceptions Survey, a national online survey of about 6,000 U.S. adults conducted annually by Georgia State from 2014 through 2018.

Journal reference:

Nyman, A.L., et al. (2019) Perceived Comparative Harm of Cigarettes and Electronic Nicotine Delivery Systems. JAMA Network Open.


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