Abstract
Association of the US Outbreak of Vaping-Associated Lung Injury With Perceived Harm of e-Cigarettes Compared With Cigarettes
Highlights
The US Food and Drug Administration acknowledges that nicotine and tobacco products exist on a continuum of risk, with e-cigarettes likely to be less harmful than combustible cigarettes because of their lower production of toxicants and carcinogens.[1,2] many smokers in England and the US believe that e-cigarettes are at least as harmful to health as combustible cigarettes.[2,3] These misperceptions likely dissuade smokers who are unable or unwilling to stop using nicotine from switching to e-cigarettes, which may have a detrimental effect on population health
The proportion who perceived e-cigarettes as less harmful than combustible cigarettes decreased significantly from 37.0% (n = 678) before to 30.9% (n = 427) after the outbreak, and significantly fewer smokers reported not knowing which product was more harmful (191 [10.4%] vs 112 [8.1%]; RR, 0.78; 95% CI, 0.63-0.98; P = .03)
In the final quarter of 2019, the percentage of individuals who perceived e-cigarette use as less harmful than cigarette smoking decreased to the lowest point recorded (239 [29.5%]; 95% CI, 26.5%-32.8%), and the percentage perceiving it as more harmful peaked (155 [19.2%]; 95% CI, 16.6%-22.0%)
Summary
The US Food and Drug Administration acknowledges that nicotine and tobacco products exist on a continuum of risk, with e-cigarettes likely to be less harmful than combustible cigarettes because of their lower production of toxicants and carcinogens.[1,2] many smokers in England and the US believe that e-cigarettes are at least as harmful to health as combustible cigarettes.[2,3] These misperceptions likely dissuade smokers who are unable or unwilling to stop using nicotine from switching to e-cigarettes, which may have a detrimental effect on population health. The recent US outbreak of vaping-associated lung injury (EVALI)[4] received extended news coverage worldwide. This study examined the extent to which perceptions of the harm of e-cigarettes compared with combustible cigarettes changed among smokers after the EVALI outbreak
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