Harm Perceptions of E‐Cigarettes and Other Nicotine Products in a UK Sample

Bottom Line: Large proportions of UK smokers and ex‐smokers overestimate the relative harmfulness of e‐cigarettes compared with smoking, misattributing smoking harms to nicotine. These misperceptions have increased over time, and it is possible that those who do not vape may not be using e-cigarettes due to these misguided concerns about harm.

Smoking tobacco cigarettes kills more than half of those with sustained use. Nicotine is the main addictive substance in smoking, but it is the other constituents that cause the harms. There are many misperceptions concerning the level of harm presented by nicotine, and the relative harm of smoking tobacco cigarettes. It is possible that misperceptions of nicotine's risks are underpinning harm perceptions of e-cigarettes.

In a large survey of British smokers and recent ex-smokers, just 11.2% responded that the health risk of nicotine in cigarettes was none or very small; 24.5% responded some but well under half; 21.8% responded approximately half the risk; 16.3% responded much more than half the risk; 11.5% responded nearly all the risk; and 14.8% responded that they did not know.

When asked whether the nicotine in tobacco cigarettes is the chemical that causes most of the cancer, 39.2% responded true (the incorrect response) and 60.8% responded false (the accurate response). 

For the relative harmfulness of e-cigarettes and tobacco cigarettes, 3.3% responded that e-cigarettes were more harmful than tobacco cigarettes, 21.8% responded equally harmful, 57.3% responded less harmful and 17.6% responded they did not know. 

When asked about the relative addictiveness of e-cigarettes compared to tobacco cigarettes, 4.7% responded that e-cigarettes are more addictive, 49.0% responded equally addictive, 25.4% responded less addictive and 20.9% responded that they did not know. 

The top five concerns for participants around e-cigarettes (at least one‐third of the sample) were:

• "Not enough research has been done to understand all the possible harms"
• "Chemicals in the liquid might be harmful"
• "Not enough quality control or regulation"
• "You don't know exactly what you are getting"
• "They may be addictive"
• "They may explode or catch fire"

The results provide greater detail on perceptions of relative harm and the correlates of harm perception among a general population sample of UK smokers and ex‐smokers. Given that vaping status was associated with harm perceptions, it is possible that those who do not vape may not be using e-cigarettes due to concerns about potential harms. This is in line with previous findings that fewer concerns about e-cigarettes harms predicted e-cigarettes use.

Read the full report here.