Worldviews and trust of sources for health information on electronic nicotine delivery systems: Effects on risk perceptions and use

Abstract

Public health agencies, the news media, and the tobacco/vapor industry have issued contradictory statements about the health effects of electronic nicotine delivery systems (ENDS). We investigated the levels of trust that consumers place in different information sources and how trust is associated with cultural worldviews, risk perceptions, ENDS use, and sociodemographic characteristics using a nationally representative sample of 6051 U.S. adults in 2015. Seventeen percent of adults were uncertain about their trust for one or more potential sources. Among the rest, the Centers for Disease Control and Prevention (CDC), health experts, and the Food & Drug Administration (FDA) elicited the highest levels of trust. In contrast, tobacco and vapor manufacturers, vape shop employees, and, to a lesser extent, the news media were distrusted. Adults who had higher incomes and more education or espoused egalitarian and communitarian worldviews expressed more trust in health sources and the FDA, whereas those identifying as non-Hispanic Black or multiracial reported less trust. Current smokers, those who identified as non-Hispanic Black or other race, had lower incomes, and espoused hierarchy and individualism worldviews expressed less distrust toward the tobacco and vapor industry. Greater trust (or less distrust) toward the tobacco and vapor industry and an individualism worldview were associated with perceptions of lower risk of premature death from daily ENDS use, greater uncertainty about those risks, and greater odds of using ENDS. Public health and the FDA should consider consumer trust and worldviews in the design and regulation of public education campaigns regarding the potential health risks and benefits of ENDS.

‘The lesser devil you don’t know’: a qualitative study of smokers’ responses to messages communicating comparative risk of electronic and combusted cigarettes

“…The scepticism may lead to continued cigarette smoking among smokers who are not ready to quit smoking. On the other hand, the use of trusted sources,29 30 38–40 statistical facts and emphasis on the known health harms of cigarettes in comparative risk messages were more compelling.…”

“…Participants demonstrated distrust for tobacco companies and organisations with commercial interests in tobacco products due to their knowledge of tobacco industry deception. Therefore, to decrease scepticism about the messages, the messages should mention a trusted source, such as the FDA 29 30…”

“…Additionally, some participants interpreted ‘less harmful’ as ‘not harmful’. This misunderstanding may also result from the modified risk claims proposed by the tobacco companies27–29 and the FDA needs to carefully review the evidence tobacco companies are providing regarding how the public interpret reduced risk claims.…”

Sources of information in health education: A cross-sectional study in Portuguese university students

“…15 In the same sense, Weaver et al found the highest levels of trust in information about health effects of electronic nicotine delivery systems in the providers and official health institutes versus the manufacturers, commercial sellers and media. 16 Some sites are not rigorous in providing information, which contributes to this lack of trust. A recent quality analysis of the reproducibility of one screening instrument to evaluate primary immunodeficiencies risk of disease showed significant deviations from the original instrument in several adaptations and variants published online, raising concerns about standards for scientific information.…”

A qualitative exploration of information-seeking by electronic nicotine delivery systems (ENDS) users in New Zealand

“…Gaps may also exist between the sources participants regard as trustworthy and those they use. 22 For example, while doctors are regarded as the most reliable source of information about ENDS’ health effects, very few participants surveyed (<7%) had actually sought ENDS information from a health professional. Instead, most turned to the internet or product packaging, or sought advice from other ENDS users.…”