US adult tobacco users' absolute harm perceptions of traditional and alternative tobacco products, information-seeking behaviors, and (mis)beliefs about chemicals in tobacco products

Abstract

Introduction Harm perceptions about tobacco products may influence initiation, continued use, and cessation efforts. We assessed associations between adult traditional tobacco product use and absolute harm perceptions of traditional and alternative tobacco products. We also described the topics individuals looked for during their last search for information, their beliefs about chemicals in cigarettes/cigarette smoke, and how both relate to harm perceptions. Methods We ran multivariable models with jackknife replicate weights to analyze data from the 2015 administration of the National Cancer Institute’s Health Information National Trends Survey (N=3376). Results Compared to never users, individuals reported lower perceived levels of harm for products they use. Among current tobacco users, ethnicity, thinking about chemicals in tobacco, and information-seeking were all factors associated with tobacco product harm perceptions. In the full sample, some respondents reported searching for information about health effects and cessation and held misperceptions about the source of chemicals in tobacco. Conclusions This study fills a gap in the literature by assessing the absolute harm perceptions of a variety of traditional and alternative tobacco products. Harm perceptions vary among tobacco products, and the relationship among tobacco use, information seeking, thoughts about chemicals in tobacco products, and harm perceptions is complex. Data suggest that some individuals search for information about health effects and cessation and hold misperceptions about chemicals in tobacco products. Future inquiry could seek to understand the mechanisms that contribute to forming harm perceptions and beliefs about chemicals in tobacco products.

Understandings of the component causes of harm from cigarette smoking in Australia

“…These results suggest that many smokers in the clearly combustion segment retain a strong implicit belief that nicotine is very harmful and that thinking about nicotine evokes negative affective associations. These results are broadly consistent with both recent US findings and findings from our earlier qualitative research .…”

Health risk perceptions and reasons for use of tobacco products among clients in addictions treatment

“…Perceived health risks of cigarettes were significantly associated with cigarette smoking; those reporting lower perceived health risk of cigarettes were more likely to be current smokers than non-smokers. This finding corresponds to findings from an earlier sample of clients in addictions treatment, and with findings from smokers in the general population, strengthening the evidence that smokers perceive lower health risk from smoking than nonsmokers do, an inaccurate and concerning perception (Bernat et al, 2017;Campbell et al, 2016;Krosnick et al, 2017;Weinstein, Marcus, & Moser, 2005). Participants who rated ecigarettes as having lower health risks were more likely to have used e-cigarettes in the past 30 days, findings which are also consistent with those within the general population of ecigarette consumers (Amrock, Zakhar, Zhou, & Weitzman, 2014;Bernat et al, 2017).…”

“…This finding corresponds to findings from an earlier sample of clients in addictions treatment, and with findings from smokers in the general population, strengthening the evidence that smokers perceive lower health risk from smoking than nonsmokers do, an inaccurate and concerning perception (Bernat et al, 2017;Campbell et al, 2016;Krosnick et al, 2017;Weinstein, Marcus, & Moser, 2005). Participants who rated ecigarettes as having lower health risks were more likely to have used e-cigarettes in the past 30 days, findings which are also consistent with those within the general population of ecigarette consumers (Amrock, Zakhar, Zhou, & Weitzman, 2014;Bernat et al, 2017). Health risk perceptions of other tobacco products were not associated with use of those products in the current study, in contrast with research that has shown lower health risk perception to be associated with product use (Bernat et al, 2017;Nyman et al, 2017;Wackowski & Delnevo, 2016).…”

“…A body of evidence indicates that lower perceived health risk of smoking is associated with higher smoking initiation (Song et al, 2009) greater continuation of smoking (Mantler, 2013) and fewer quit attempts (Savoy et al, 2014) within the general population. Although less thoroughly studied, health risk perception of alternative tobacco products also appears to be associated with product use; use of a product is associated with lower risk perception for that product relative to non-use (Bernat, Ferrer, Margolis, & Blake, 2017;Nyman, Sterling, Majeed, Jones, & Eriksen, 2017;Wackowski & Delnevo, 2016).…”

Association between changes in harm perceptions and e-cigarette use among current tobacco smokers in England: a time series analysis

“…Previous research has identified individual-level predictors of harm perceptions and has found significant differences by age, sex and social grade: younger age [11,16,20,25], male sex [11,20,21,27,29] and higher income/education [16,20,21,25] are associated with greater odds of endorsing the statement that e-cigarettes are less harmful than conventional cigarettes. However, some studies have found that older age [13,14,27], female sex [16] and lower income/education [27] are associated with greater odds of believing that e-cigarettes are less harmful.…”