- Large-scale surveys show a sharp rise in smokers who think vaping is as harmful, or more harmful, than smoking
- In the U.S., 71.3% of smokers now say vapes are equally harmful as cigarettes
- In the U.K., 33.7% of smokers believe vaping and smoking carry the same risks
- Researchers warn misperceptions could reduce uptake of safer alternatives to cigarettes
Public understanding of the risks of vaping is moving further away from the evidence, according to a new letter published in Nicotine and Tobacco Research by the Centre for Substance Use Research in Glasgow.
The letter, by academics Neil McKeganey, Dylan Grier, and Gabriel Barnard, examined large-scale surveys in both the U.S. and the U.K. It found that rising numbers of smokers believe vapes are either just as harmful as smoking, or even more dangerous.
The researchers wrote: “On the continuum of risk, it is recognised that these devices are less harmful than combustible cigarettes and expose users to substantially fewer harmful and potentially harmful chemicals than combustible cigarettes.
“Along with reducing health risks, e-cigarettes have also been shown to help adults to quit smoking – being associated with both an increased number of quit attempts and an increased likelihood that those quit attempts will have been successful.”
Sharp rise in misperceptions
In the U.S., the Population Assessment of Tobacco and Health (PATH) study has tracked tobacco attitudes since 2013. In response to the question “Is using e-cigarettes or other electronic nicotine products less harmful, about the same, or more harmful than smoking cigarettes?”, the authors found a sharp increase in misperceptions among smokers.
“The proportion of PATH study respondents aged 18 years and older who currently smoked, and who perceived e-cigarettes to be more harmful than combustible cigarettes, has risen from 6.2 per cent in Wave 1 (2013 to 2014) to 17.6 per cent in Wave 7 (2022 to 2023).
“Over the same period the proportion of adults aged 18 years and older who currently smoked who perceived e-cigarettes and combustible cigarettes as having the same level of harm has increased from 38.4 per cent in Wave 1 to 71.3 per cent in Wave 7.”
In the U.K., the Smoking Toolkit Study has tracked attitudes since 2006. “In assessing changes in harm perceptions of e-cigarettes relative to combustible cigarettes among adults aged 18 years and older who currently smoke, the proportion who perceive e-cigarettes to be more harmful than combustible cigarettes has risen from 10.8 per cent in 2014 to 23.3 per cent in 2023, while the proportions of those who perceived e-cigarettes and combustible cigarettes to be equally harmful has risen from 30.3 per cent in 2014 to 33.7 per cent in 2023.”
The data also suggested that U.S. smokers may be more fixed in their views. “In the U.S. 0.9 per cent of adults currently smoking at Wave 7 (2022 to 2023) indicated that they ‘do not know’ how harmful these products are compared to each other, whereas in the U.K. 16.4 per cent of adults currently smoking indicated that they did not know how the harms of e-cigarettes and combustible cigarettes compared.”
Media influence and communication gap
The authors highlighted a possible explanation for the disconnect between scientific evidence and public belief. “Most peoples’ access to research findings is through the media. On that basis it is possible that the negative coverage e-cigarettes often receive within the media may have influenced public perceptions of the harms of these devices.”
They added that conventional ways of sharing research findings are unlikely to reach the public. “The favoured means of disseminating research findings through peer reviewed papers in academic journals and presentations of research findings at academic conferences, are unlikely to be seen by members of the general public and unlikely to influence their perception of these products.”
The paper suggested researchers could look to social media platforms for wider reach. “Such social media sites may offer a much better means of communicating the relative risk of e-cigarettes and combustible cigarettes than any of the conventional media.”
Why misperceptions matter
The study warned that these misunderstandings are not trivial. “Whilst the results of research are likely to be influential in determining whether these products are available for sale within a given area, the question of whether these products are actually used by consumers is more likely to be influenced by how those products are actually perceived.
“The fact that so many people within the U.S. and the U.K. believe that e-cigarettes are as harmful, or more harmful, than combustible cigarettes very probably influences the extent to which these devices are being used.”
The paper is published in Nicotine and Tobacco Research as an “uncorrected manuscript,” meaning it has been accepted for publication but not yet through final editing.
