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expert reaction to research on perceptions of e-cigarettes vs smoking in the US

Research published in JAMA Network Open looked at the perception of health risks of smoking and e-cigarettes and found that the proportion of US adults who perceived e-cigarettes to be as harmful as or more harmful than cigarettes increased substantially from 2012 to 2017.

Prof Linda Bauld, Bruce and John Usher Professor of Public Health at the Usher Institute, University of Edinburgh, said:

“These worrying findings provide another example of how poorly conducted or reported research, resulting in scare-mongering headlines, can harm health. The authors found that an increasing proportion of Americans believe vaping is as harmful or more harmful than smoking, a perception that is simply wrong from what we know to date. As the authors point out, these perceptions are likely to deter smokers from switching to e-cigarettes, a less harmful alternative to deadly cigarettes. 

“This problem appears particularly acute in the USA, where we are also seeing misinformation about other topics, like vaccination, affecting uptake of life-saving public health measures. But we have a similar, albeit less stark, problem with beliefs about vaping in the UK. While up to half of American adults now believe vaping is as harmful as smoking, one in four adults in Great Britain think e-cigarettes are as harmful or more harmful than cigarettes, and these misperceptions have grown through time. Fortunately in the UK, government, research funders and charities are working to convey accurate information about vaping to smokers, which is not always the case in the USA.”

Prof Robert West, Professor of Health Psychology and Director of Tobacco Studies at UCL, said:

“Even those experts who have deep concerns about e-cigarettes agree that they are likely to be substantially less harmful than tobacco cigarettes, so this finding reveals a failure of public health messaging which means that smokers who might consider switching are not able to make an informed choice. The commentary by Glantz that accompanied the article provides a possible clue as to why such misconceptions are prevalent; it gives the appearance of being balanced to those not familiar with the evidence while in tone, language and interpretation of findings it presents a highly one-sided polemic against e-cigarettes.”

Prof Peter Hajek, Director of the Tobacco Dependence Research Unit, Queen Mary University of London (QMUL), said:

“These are stunning results showing a disastrous level of misinformation that is being spread about e-cigarettes and vaping. While there is a strong scientific consensus that vaping poses only a small fraction of the risks of smoking, waves of misinformation are preventing smokers from switching to vaping – and avoiding unnecessary heart disease, lung disease and cancer.”

‘Changing Perceptions of Harm of e-Cigarette vs Cigarette Use Among Adults in 2 US National Surveys From 2012 to 2017’ by Jidong Huang et al. was published in JAMA Network Open at 3pm UK time on Friday 29 March 2019.

Declared interests

Prof Bauld is CRUK/BUPA Chair in Behavioural Research for Cancer Prevention, Cancer Research UK; Deputy Director, UK Centre for Tobacco and Alcohol Studies; and Honorary Professor, University of Stirling 

Prof Robert West undertakes research and consultancy for companies that develop and manufacture smoking cessation medicines but not e-cigarettes or tobacco products. His research is funded by Cancer Research UK

Prof Hajek: none to declare

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