Public health messages warning of the dangers of vaping may be contributing to a growing misperception that vapes are just as harmful as smoking, a new King’s College London review has said.
Published in Addiction, the systematic review examined 85 studies assessing how vaping harm perceptions can be changed and whether these perceptions influence vaping and smoking behaviours.
The researchers found that while messages about the harms of vaping can effectively increase perceived risk, especially among young people, many also lead to the incorrect belief that vaping is as or more harmful than smoking.
Vaping misconceptions increasing
The authors said: “This may, in part, explain why relative vaping misperceptions are increasing alongside more negative information about vaping in the media and some public health campaigns.”
Dr Katie East, Associate Professor in Public Health at Brighton and Sussex Medical School, said: “In this review, we examined what changes people’s perceptions of the risks of vaping and how these perceptions affect smoking and vaping behaviours.
“Messages warning about the dangers of vaping were often effective, especially among young people – but some also led to the false belief that vaping is as harmful as smoking. We also found that what people believe really matters.
“For adults who smoke, misunderstanding relative risks can discourage them from quitting smoking and switching to vapes. Clear, evidence-based communication is needed to enhance public understanding.”
Misconceptions widespread among adults
Among adults who smoke, misperceptions are widespread. More than seven in 10 adults who smoke inaccurately believe that vaping is as, or more, harmful than smoking, according to the review.
It found that interventions focused on the harms and addictiveness of vaping (so-called “absolute harm” messages) were effective in changing perceptions.
“Twelve out of 14 studies in young people and 16 out of 23 in adults showed an alteration in understanding,” the review said.
But the authors added: “This theme of communication did also increase the misperception that vaping is as harmful as smoking.”
Smokers most likely to hold misconceptions
Professor Ann McNeill, Professor of Tobacco Addiction at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), said: “A quarter of people who smoke cigarettes have never tried vaping and they are the most likely to wrongly believe that vaping is as, or more, harmful than smoking.
“Our research shows that these misperceptions are likely discouraging people from using vapes to stop smoking which other evidence shows are more effective stop-smoking aids than licensed nicotine replacement therapies.
“Our research also shows that misperceptions can be corrected when people are given accurate information – this is urgently needed given smoking kills nearly two-thirds of those who smoke.”
Beliefs influence behaviour
The review also found that people’s beliefs about harm directly influenced behaviour.
“Perceiving vaping as harmful deterred vaping among both young people and adults, while misperceiving vaping as equally/more harmful than smoking prevented adults from quitting smoking.”
Professor Leonie Brose, Professor of Addictions & Public Health at IoPPN, added: “Public perceptions of the harmfulness of vaping versus smoking are more out of line with the evidence than ever before. Our comprehensive review demonstrates that these perceptions can be influenced and that they predict smoking and vaping behaviours.
Tobacco and Vape Bill
“As England prepares to implement the Tobacco and Vapes Bill – designed to create a smokefree generation and tighten regulations on vaping – it is essential to ensure the public receives accurate information to maximise health benefits and avoid unintended consequences, such as individuals switching from vaping to the far more harmful smoking due to misperceptions.”
The review concludes that future interventions must clearly communicate both the risks and the relative safety of vaping compared to smoking, especially as public health policy evolves.
It says: “Ultimately, interventions should communicate that vaping carries risks but is substantially less harmful than smoking, in line with current evidence.”
