A new study reveals that most adults hold beliefs about the harms from nicotine that are opposite from what scientists have concluded.
The findings, presented at the Society for Research on Nicotine and Tobacco 24th Annual Meeting in Baltimore, Maryland, highlight the need to correct misperceptions about the harmfulness of nicotine so that adults can make informed decisions about use of nicotine-containing and lower risk tobacco products.
Nicotine is present in combustible cigarettes, e-cigarettes and FDA-approved nicotine replacement therapies used to help smokers stop smoking. The FDA and other authorities have concluded that there is a continuum of risk for nicotine and tobacco products, with combustible cigarettes by far the most hazardous and nicotine replacement therapies as the least hazardous. To examine adults’ knowledge of tobacco and nicotine harmfulness, researchers analyzed data from 1,736 US adults in the government-run 2017 Health Information National Trends Survey (HINTS-FDA Cycle 2).
Adults’ beliefs about nicotine and tobacco products are not completely wrong. For example, a majority of adults (84.7%) correctly knew that nicotine is the substance that makes people want to smoke, and 96.2% knew that cigarettes are harmful. On the other hand, other results revealed important misunderstandings that may have critical consequences for health.
Among all adults, 52.9% incorrectly believed that nicotine is the substance causing most of the cancer caused by smoking, and an additional 21.2% did not know whether nicotine causes most cancer caused by smoking. Cigarette smokers were significantly more likely than e-cigarette users to incorrectly believe that nicotine causes most of the cancer caused by smoking (52.5% vs. 14.6%). In addition, while experts continue to debate the magnitude of the difference in risk between e-cigarettes and cigarettes, just 31.6% of smokers agreed that e-cigarettes are less harmful than cigarettes—including only 3.4% who are plausibly “correct” in believing they are much less harmful than combustible cigarettes.
“That adults’ misperceptions about the health effects of nicotine persist despite the long-term availability of FDA-approved over-the-counter nicotine replacement products is troubling and needs to be addressed with clear communications to the public—especially smokers—that nicotine is not what is causing smoking-related disease,” said Karen K. Gerlach Ph.D., M.P.H., the lead author on the study. “Leading public health experts have called for trusted authorities to communicate clearly about nicotine to smokers, which should help them understand that there is a continuum of risk across nicotine-containing products and use that understanding to help them reduce risks to their health.”