Harm perceptions of electronic cigarettes and nicotine: A nationally representative cross-sectional survey of young people in Great Britain

Sara C. Hitchman,Hazel Cheeseman,Katherine East,Leonie S. Brose,Ann McNeill,Deborah Arnott

doi:10.1016/j.drugalcdep.2018.08.016

Sara C. Hitchman, Hazel Cheeseman

Open Access

https://doi.org/10.1016/j.drugalcdep.2018.08.016

Copy DOI

Abstract

BackgroundE-cigarettes often contain nicotine without the most harmful constituents of tobacco smoke. AimsThis study aims to assess prevalence and correlates of accurately perceiving e-cigarettes as less harmful than cigarettes and that none or a small amount of the harm from smoking comes from nicotine. MethodsCross-sectional survey of 2,103 11–18-year-olds in Great Britain in 2016. Prevalence of e-cigarette and nicotine harm perceptions were calculated. Logistic regressions assessed associations between accurate e-cigarette and nicotine harm perceptions and smoking, e-cigarette use, gender, age, region, social grade, family smoking, family e-cigarette use, smoking friends, public approval of smoking, and public approval of e-cigarettes. Associations between accurate e-cigarette and nicotine harm perceptions were also assessed. ResultsMost (63.4%) accurate e-cigarette harm perceptions were higher among those aged 16+ (OR = 1.89 [95%CI = 1.45–2.47]), 14–15 (OR = 1.29 [1.00–1.65]), who tried/used an e-cigarette sometimes (OR = 1.51 [1.03–2.21]), with family e-cigarette use (OR = 2.11 [1.46–3.04]), who perceived public disapproval of smoking (OR = 2.11 [1.18–3.77]) and approval of e-cigarettes (OR = 2.44 [1.73–3.45]), and with accurate nicotine harm perceptions (OR = 2.05 [1.28–3.28]). Accurate nicotine harm perceptions were higher among those aged 16+ (OR = 2.60 [1.62–4.16]), from North England (OR = 1.87 [1.02–3.43]) and Wales/Scotland (OR = 2.61 [1.35–5.03]) vs. London, with family smoking (OR = 1.59 [1.05–2.42]), and with accurate e-cigarette harm perceptions (OR = 2.12 [1.32–3.41]). ConclusionsMany young people have inaccurate harm perceptions of e-cigarettes and nicotine. Accurate e-cigarette and nicotine harm perceptions were associated with one another. E-cigarette use was associated with accurate e-cigarette but not nicotine harm perceptions; smoking was not associated with either.

Highlights

Tobacco smoking is the leading cause of preventable death and disability worldwide (WHO, 2005, 2015)
We found that very few (9%) accurately perceive that nicotine causes little of the health harms of smoking
Accurate relative harm perceptions of e-cigarettes were higher among those who were older, had tried or used an e-cigarette sometimes, had at least one family member who used e-cigarettes, had no friends who smoke, perceived that the public approve or neither approves nor disapproves of ecigarettes, and perceived that the public disapproves of smoking

Summary

Introduction

Tobacco smoking is the leading cause of preventable death and disability worldwide (WHO, 2005, 2015). Similar patterns are seen among young people in Great Britain, and the proportion who accurately perceive ecigarettes as less harmful than smoking decreased from 73% in 2013 through 67% in 2014 and 2015 to 62% in 2016 (Eastwood et al, 2017). Aims: This study aims to assess prevalence and correlates of accurately perceiving e-cigarettes as less harmful than cigarettes and that none or a small amount of the harm from smoking comes from nicotine. Associations between accurate e-cigarette and nicotine harm perceptions were assessed. E-cigarette use was associated with accurate e-cigarette but not nicotine harm perceptions; smoking was not associated with either

Objectives

Methods

Conclusion