It Is About Trust: Trust in Sources of Tobacco Health Information, Perceptions of Harm, and Use of E-Cigarettes

Abstract

Introduction Recent research has highlighted disparities in people who perceive as trustworthy sources of e-cigarette health information. Research has yet to examine if trusting a particular source of information is associated with use of e-cigarettes or perceptions of e-cigarette harm. We use a nationally representative survey of American adults to address these gaps in knowledge. Methods This study used data from the Health Information National Trends Survey (N = 3738). Logistic regression models were used to calculate odds of ever using e-cigarettes and perceived health harm of e-cigarettes. Trust in seven different sources of e-cigarette health information served as the independent variables. Models accounted for confounders. Results Trusting religious organizations “a lot” as sources of e-cigarette health information was associated with lower odds of ever using e-cigarettes and with lower odds of perceiving e-cigarettes as less harmful than conventional cigarettes. Trusting e-cigarette companies “a lot” as sources of e-cigarette health information was associated with lower odds of viewing e-cigarettes as harmful to health. Conclusion Trusting health information about e-cigarettes from sources in the medical or public health field was not associated with lower use of e-cigarettes or viewing e-cigarettes as more harmful. Trusting health information from e-cigarette companies yielded perceptions of e-cigarette harm that are consistent with messaging provided by these companies. Implications As use of e-cigarettes continues to climb, leveraging different modes of health communication will be critical to both discourage e-cigarette use among never-smokers and, potentially, to encourage use of e-cigarettes as an option to achieve smoking cessation or reduce the harm of tobacco products. Our findings suggest that religious organizations may be helpful in communicating anti-e-cigarette messages.

Does the content and source credibility of health and risk messages related to nicotine vaping products have an impact on harm perception and behavioural intentions? A systematic review

“…After removal of duplicates and publications that did not meet the inclusion criteria, a total of 31 articles were included [7,8,24–28,34–57] (Table 3) reporting results from studies involving a total of 52 425 participants (ranging from 95–16 051). Twenty‐six of the included studies were experiments and the remaining were cross‐sectional surveys.…”

“…Whereas the majority of the studies ( n = 23) randomly assigned participants to an intervention, only five studies [36,42,46,49,55] had a follow‐up rate of more than 80%. All cross‐sectional studies included had an overall quality of either average (score 5 of 9) [44] or above average (score = ≥7 of 9) [39,50,51,57], according to the Newcastle–Ottawa scale. Details of the risk of bias assessment for included studies are presented in Supporting information File 2.…”

“…However, those who had used NVPs reported significantly lower trust in public health agencies and higher trust in the NVP industry compared to never users [39], and these groups are more likely to be from racial/ethnic minority, low income or low education groups [50,51]. Trust in health information from public health agencies [39] and religious organizations [57] were associated with lower odds of; (i) NVP use and (ii) perceiving NVPs as less harmful, whereas those who trusted information from NVP companies were more likely to perceive NVPs as less harmful than combustible cigarettes [39,50,57].…”

The missing role of moral values in anti‐vaping messaging

“…However, their study did not test specific moral messaging in anti‐vaping campaigns nor did they explore potential explanations for the roots of moral values (i.e., religiosity). Additionally, Alcalá and Shimoga (2020) state that to the best of their knowledge, there are no studies examining the relationship between religion and vaping, but such research is critical because tapping into consumers' individual moral values as well as the support associated with a prominent source of moral values (religious institutions) may be an effective way to decrease vaping behavior.…”

Primary Care Physician Perspectives on Recommending E-cigarettes to Smokers: a Best-Worst Discrete Choice Experiment

“…23 Most smokers visit their PCP annually 24,25 and patients view PCPs as their most trusted source of information on the health effects of ecigarettes. 26 Thus, clinical encounters present an opportunity for PCPs to inform their patients about the relative risks and benefits of e-cigarette use.…”