Perceptions Of Harm Research Articles

Clearing the air: Heightened perception of harm from secondhand cannabis smoke exposure is associated with no in-home cannabis smoking in a 21-country convenience sample.

As countries adopt more lenient cannabis use policies, perception of harm from secondhand cannabis smoke (SHCS) exposure is decreasing and most cannabis smoking is taking place at home. We quantified the relationship of reported in-home cannabis smoking with perceived harm from SHCS exposure. The analytic sample comprised 28,154 adult respondents, from 21 countries, to the annual cross-sectional Global Drug Survey (2021) of users of licit or illicit drugs. Respondents reported perception of harm to non-smoking residents from SHCS exposure and past 30-day cannabis smoking in the home by anyone. Logistic regression estimated covariate-adjusted odds ratios and 95 % confidence intervals of in-home cannabis smoking (yes/no). The association between harm perception and in-home cannabis smoking by country of residence was also quantified. Sixty-one percent reported no in-home cannabis smoking in the last 30 days; mean perception of harm of SHCS exposure on a 10-point scale was 5.2. Those at the 75th (vs 25th) percentile of perceived harm had 70 % higher odds (OR = 1.7, 95 % CI = 1.6-1.8) of no in-home cannabis smoking. In all countries of residence, higher perception of harm was associated with reporting no in-home cannabis smoking, although not all were statistically significant. The strongest association was seen in Sweden (OR = 3.9, 95 % CI = 1.5-11.9) and New Zealand (OR = 2.3, 95 % CI = 2.0-2.7). Respondents who perceived SHCS as harmful were less likely to report in-home cannabis smoking. If this association subsequently proves causal, increasing awareness of the harms associated with SHCS exposure could substantially reduce residential cannabis secondhand smoke exposure.

Role of social-cognitive factors in the relationship between e-cigarette use and subsequent cigarette smoking among U.S. youth: A causal mediation analysis

ObjectiveE-cigarette use is associated with subsequent cigarette smoking among youth. The current study examined the mediating role of social-cognitive factors in this association. MethodsData from four waves of the Population Assessment of Tobacco and Health study (2013/4 – 2017/8) were analyzed. Among youth who had heard about e-cigarettes at Wave 1 but never used cigarettes before Wave 2, we conducted both causal and traditional mediation analyses to examine the mediated effect of social-cognitive factors (including relative harm perception of e-cigarettes versus cigarettes, harm perception of e-cigarette use, perceptions of addictiveness of e-cigarette use, and e-cigarette use among best friends) in the association between e-cigarette use and subsequent cigarette ever or current smoking, adjusting for covariates. We included sampling weights in all analyses; hence, results are generalizable to the U.S. youth (12 – 14 years) from the 2013–2014 cohort. ResultsResults from causal mediation analyses indicated that the total effect of e-cigarette use, compared to no use, increased the risk of cigarette ever smoking (20.9 %) and current smoking (4.6 %). A portion of this effect (4.2 % − 15.1 % for ever smoking; less than 10.6 % for current smoking) can be attributed to changes in social-cognitive factors induced by e-cigarette use. However, these mediated effects were small in magnitude relative to their standard errors and not statistically significant. Results from the traditional mediation analyses largely aligned with these findings, except for a few small sized pathways. ConclusionsFor the U.S. youth population, social-cognitive factors may only minimally or not at all mediate the association between e-cigarette use and subsequent cigarette smoking. Further investigation into the mediation role of social-cognitive factors is warranted. Tobacco control interventions that focus on cigarette smoking initiation among youth should target other mediating factors.

Reducing the harms of cannabis use in youth post-legalization: insights from Ontario youth, parents, and service providers

BackgroundCanada has one of the highest prevalence of cannabis use globally, particularly among young adults aged 20–24 (50%) and youth aged 16–19 (37%). In 2018, Canada legalized recreational cannabis with the aim of protecting youth by restricting their access and raising public awareness of health risks. However, there has been limited qualitative research on the perceptions of harms associated with youth cannabis use since legalization, which is crucial for developing effective harm reduction strategies. This qualitative study examined perceptions of cannabis use among youth from the perspectives of youth, parents, and service providers. We explored how participants described the perceived risks or harms associated with youth cannabis use, as well as how they described their own and others’ approaches to reducing cannabis-related risks and harms.MethodsThis qualitative study used a community-based participatory research approach in partnership with Families for Addiction Recovery (FAR), a national charity founded by parents of youth and young adults with addiction issues. Virtual semi-structured interviews were conducted, and the data were analyzed using thematic analysis.ResultsThe study included 88 participants from three key groups (n = 31 youth, n = 26 parents, n = 31 service providers). Two main themes emerged regarding perceived risks or harms associated with cannabis use: (1) concerns about cannabis-related risks and harms, including addiction, brain development, impact on family, and various adverse effects on areas such as motivation, concentration, finances, employment, education, physical and mental health; and (2) minimization of risks and harms, featuring conflicting messages, normalization, and perceptions of cannabis being less harmful than other substances. Additionally, two themes related to harm reduction approaches were identified: (1) implementation of harm reduction, and (2) challenges in implementing a harm reduction approach. Specific challenges for each participant group were noted, along with structural barriers such as unavailable and inaccessible services, easy access to cannabis, inadequate public education, and insufficient information on lower-risk cannabis use guidelines.ConclusionsYouth cannabis use is a significant public health concern that requires a multi-pronged approach. Developing youth-centered harm reduction strategies that recognize the developmental needs and vulnerabilities of youth, as well as the important role of families, is imperative.

‘Vaping is a break from all of that’: Exploring attitudes, harm perceptions, cessation barriers and social dynamics among people who vape

Objective: Vaping, initially a smoking cessation aid, is now a widespread recreational activity sometimes associated with perceived health concerns. This study explored attitudes, harm perceptions and cessation barriers in the context of participants’ vaping behaviours, guided by the theoretical lens of fundamental social causes. Design and Setting: The study focused on a subset of 571 current adult vapers from a larger survey investigating vaping attitudes. It analysed open-text survey responses relating to vaping behaviours. To analyse the responses, we employed layered analyses, using deductive conceptual mapping to inform an inductive thematic content analysis. Results: Participants mentioned nuanced vaping risks, citing cancer and respiratory concerns, often comparing them to tobacco’s well-known harmful effects. Despite acknowledging vaping’s potential harms, participants perceived the practice to be less harmful than smoking, emphasising relative safety. Some viewed vaping positively for former smokers, contingent on regulated products. This complex attitude balance reflected the intricate interplay between health concerns and social dynamics. Recurrent vaping symbolised consistent engagement, with cravings and widespread availability associated with quitting challenges. Conclusions: Participants’ nuanced perceptions of health risks reflect a harm duopoly, resembling illicit drug harm tiering. There is a complex interplay between health knowledge and social influences in the context of vaping behaviours. Study findings underscore the need for messaging interventions discouraging vaping among those who do not smoke tobacco to consider these health and social dynamics, leveraging collaborative design.

Use, perceptions, and effectiveness of e-cigarettes for smoking cessation among older adults in England: a population study, 2014–2024

BackgroundThis study aimed to characterise patterns of tobacco smoking and vaping among older adults (≥ 65 years) in England, to explore harm perceptions of e-cigarettes among those who smoke, and to estimate the real-world effectiveness of e-cigarettes for helping older adults to stop smoking.MethodsData were collected as part of a representative monthly cross-sectional household survey in England between April 2014 and April 2024 (n = 197,219). We analysed differences between older (≥ 65 years) and younger/middle-aged adults (18–64 years) in (a) time trends in tobacco smoking and vaping, (b) harm perceptions of e-cigarettes vs. cigarettes (adjusting for gender, socioeconomic position, and vaping status), and (c) the real-world effectiveness of e-cigarettes for smoking cessation (adjusting for gender, socioeconomic position, characteristics of the quit attempt, and use of other evidence-based cessation aids).ResultsTobacco smoking prevalence remained relatively unchanged over time among older adults (at ~ 9%; 9.5% [8.5–10.6%] in April 2014 and 8.7% [7.7–9.8%] in April 2024) but vaping prevalence increased (from 2.1% [1.6–2.7%] to 3.7% [3.0–4.6%], respectively). These trends differed from those observed among younger/middle-aged adults, among whom there was a clear decline in smoking (from 21.8% [21.0–22.7%] to 18.2% [17.3–19.0%]) and a larger increase in vaping (from 5.6% [5.2–6.1%] to 16.2% [15.3–17.0%]). Older adults were consistently less likely than younger/middle-aged adults to use e-cigarettes to support attempts to quit smoking (26.8% [17.2–39.3%] vs. 43.7% [39.6–48.0%] in April 2024). Older smokers reported greater uncertainty about the harms of e-cigarettes compared with cigarettes (ORadj = 2.48 [2.28–2.69]). E-cigarettes appeared to be effective for helping older adults to stop smoking (ORadj = 1.50 [0.96–2.34]); whether effectiveness was lower than for younger/middle-aged adults was inconclusive.ConclusionsOver the past decade, smoking prevalence has remained stable among older adults while decreasing among the rest of the adult population in England. Older adults are more unsure about the relative harms of e-cigarettes and less likely to use them to support attempts to quit smoking, despite evidence that they are effective for smoking cessation in this population.

A playbook for mapping adolescent interactions with misinformation to perceptions of online harm

Digital misinformation is rampant, and understanding how exposure to misinformation affects the perceptions and decision-making processes of adolescents is crucial. In a four-part qualitative study with 25 college students 18–19 years old, we found that participants first assess the severity of harms (e.g., emotion, trust) that misinformation can cause, and then think about the possibilities for reputation harm, discrimination harm, or safety harm for certain kinds of misinformation. Qualities of misinformation including mis-contextualization, deceptive imagery, and impersonation factor into adolescent assessments. From these qualities, we developed a playbook for understanding adolescents’ perceptions of the harms caused by digital misinformation. This playbook can be used by researchers and technologists working to enhance and develop online governance standards by creating digital navigation practices to mitigate misinformation-related harm towards adolescents.

When Things Go South, It Does Affect You: Perceptions of Vibrio-Related Occupational Risk and Harm Among Chesapeake Bay, USA,-Based Watermen.

Following a grounded theory approach, we conducted semi-structured interviews with watermen and related workers who fish and harvest shellfish in the Chesapeake Bay, USA, to investigate risk perceptions and understanding, and compliance with regulations intended to reduce worker and consumer illnesses and injuries from pathogen exposures. Worker and consumer illnesses and injuries, and threat of fishery closures-with regulatory and organizational factors-influence this workforce. Our findings support interventions that promote monitoring, surveillance, and awareness of Vibrio-related risk among watermen, regulatory officials, medical professionals, and the public.

Exacerbation of paranoia-like thoughts following exposure to common misophonia trigger sounds

Paranoia-like thoughts refer to heightened suspicions and unfounded beliefs about being watched or persecuted by others. Recent research has found a significant correlation between misophonia symptoms, a form of decreased sound tolerance, and paranoia-like thoughts, both of which are linked to heightened negative emotions in clinical and non-clinical populations. Notably, it has been observed that misophonia may also be associated with the tendency to attribute hostile intent to those producing triggering sounds, a feature consistent with paranoid ideation (i.e., perceptions of intentional harm). However, existing research is based on correlational data, limiting causal inference. Therefore, an online study involving a non-clinical sample (N = 487) employed an experimental approach to examine the relationship between misophonia symptoms, negative emotional response, and paranoia-like thoughts. Participants were randomly assigned to one of four task conditions, each related to exposure to different stimulus types: orofacial human-produced sounds, non-human sounds, sounds without visual context, or visuals devoid of sound. The results of mixed model ANOVA and mediation analysis revealed that exposure to common misophonia trigger sounds with a human-related visual context raised, but not significantly, the levels of paranoia-like thoughts. However, it did lead to a significant increase in negative emotions, which, in turn, proved to be a significant mediator of an increase in paranoia-like thoughts. Conversely, exposure to non-human sounds or to only audio/visual stimuli either decreased both negative emotions and paranoia-like thoughts or showed no significant change. This emphasized the role of context and the involvement of negative emotional response to human-made sounds in amplifying paranoia-like thoughts. Importantly, this effect was observed in individuals who do not meet the provisional diagnostic criteria for misophonia, suggesting that symptoms of misophonia may extend beyond clinical diagnoses, with milder manifestations potentially being present within the general population.

Morality in Our Mind and Across Cultures and Politics.

Moral judgments differ across cultures and politics, but they share a common theme in our minds: perceptions of harm. Both cultural ethnographies on moral values and psychological research on moral cognition highlight this shared focus on harm. Perceptions of harm are constructed from universal cognitive elements-including intention, causation, and suffering-but depend on the cultural context, allowing many values to arise from a common moral mind. This review traces the concept of harm across philosophy, cultural anthropology, and psychology, then discusses how different values (e.g., purity) across various taxonomies are grounded in perceived harm. We then explore two theories connecting culture to cognition-modularity and constructionism-before outlining how pluralism across human moral judgment is explained by the constructed nature of perceived harm. We conclude by showing how different perceptions of harm help drive political disagreements and reveal how sharing stories of harm can help bridge moral divides.

Does Use of Generic Depictions or Scenarios Matter in Perceptions of Crime Seriousness? An Empirical Test

This study examined the influence of crime type and crime representation in survey design on perceptions of crime severity using one-line crime descriptions and crime vignettes. A unique feature of the study was the use of hate crime as an offence category. A sample of 917 university students completed an online questionnaire measuring perceptions of crime severity for one-line crime descriptions as well as crime scenarios based on actual court cases. Consistent with past research, the results showed that both perceptions of wrongfulness and harmfulness are strong predictors of perceived crime seriousness. Violent crimes ranked highest on measures of wrongfulness, harmfulness, and seriousness, while property crimes like break and enter tended to be ranked lowest in perceived severity. Hate crime was viewed as quite serious by respondents and was rated equivalent to high-scale fraud embezzlement in terms of severity. Comparisons between responses to one-line crime descriptions and crime scenarios revealed that scenarios elicited significantly stronger severity ratings, although hierarchical rankings for crime type remained similar. The representation of crime in academic research may affect participant responses. It is recommended that researchers consider the impact the choice of crime representation in survey tools has on measures of perceived crime severity.

Moral judgments of outgroup cultural use.

Outgroup cultural use elicits controversy, including about whether it is immoral. The objective of the current work was to ask how laypeople morally evaluate individuals who adopt elements of outgroup culture for their own use and to probe a psychological mechanism underlying these evaluations. In three studies, participants provided moral evaluations of actors who engaged in outgroup versus ingroup cultural use. In Study 2, participants additionally rated how harmful each actor's behavior was; in Study 3, participants learned whether or not each behavior caused harm. Study 1 demonstrated the basic effect that participants rated actors who engaged in outgroup cultural use as less moral than actors who did not. Two preregistered follow-up studies highlighted the role of perceived harm in these moral judgments, as greater perceptions of harm led to harsher moral judgments of actors who used outgroup cultural elements among both Black and White perceivers. By integrating work on intergroup relations and moral psychology, the current research suggests that some forms of outgroup cultural use may signal a moral shortcoming for high-status actors and is among the first to illuminate the cognitive processes driving these moral judgments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring cannabis information and perceptions of cannabis harms among patients with cancer.

361 Background: Cannabis use is rising among both the general and cancer populations. While the impact of cannabis on cancer care remains unclear, many patients who use cannabis report improvement in their cancer-related symptoms. However, little is known about the potential impact of cannabis on cancer development and treatment outcomes. Understanding patient beliefs about cannabis risks and their awareness of information about cannabis use may be important for future patient education. Here, we explored patient perceptions of harms and information-seeking habits on cannabis. Methods: Patients with cancer were recruited across outpatient ambulatory clinics at the Princess Margaret Cancer Centre (Toronto, Canada) through convenience sampling from July to August 2023. A one-time, paper-based, self-administered questionnaire was used to assess sociodemographic characteristics, perceptions of cannabis harms, and awareness of cannabis information. Multivariable regression analysis was used to identify factors associated with perceptions of cannabis use. Results: Among 243 participants, median age was 65 years, 45% reported lifetime cannabis use (12% were using cannabis at the time of survey), 50% were cigarette smokers, 62% were not employed full-time, and 77% spoke English as a primary language at home. Half (51%) of the participants reported being worried about the potential impacts of cannabis on their health. Current tobacco users (aOR=0.46 [0.19-1.07], p=0.07), primary English speakers at home (aOR=0.53 [0.28-1.01], p=0.06) and those not currently employed (aOR=0.57 [0.33-0.99], p=0.04) were less worried about the effect of cannabis on their health. Despite the perceived harms of cannabis, 84% of participants never sought cannabis-related information, while 40% wanted to know more about the influence of cannabis on cancer risk and treatment. Furthermore, Most (90%) participants reported never having discussed cannabis with their oncologists, but 93% felt it was important for healthcare providers to ask patients about cannabis use. Conclusions: Many patients with cancer are worried about the impact of cannabis on their health and want to know more about cannabis use in cancer care. Most patients report it is important for healthcare providers to have discussions about cannabis use. With the rising prevalence of cannabis use among patients with cancer, validated tools to assess cannabis use and cannabis-related educational resources specific to cancer risk and treatment outcomes should be explored to help address informational needs.

Out of sight, out of mind: How high-level construals can decrease the ethical framing of risk-mitigating behavior.

Organizational failures often cause significant harm to employees, the organization itself, and the environment. Investigations of failures consistently highlight how key employees behaved in (perhaps unintentionally) unethical ways that de-prioritized safety, such as investing fewer resources in safety (vs. other priorities) over time. Drawing on these investigations, we suggest a previously underexplored theme could explain why organizational failures persist and why employees did not "see" the potential for their behaviors to cause harm to others: Employees were distanced from where the harm eventually occurred, either in terms of space (e.g., being located miles away from the job site) or time (e.g., making decisions that would not have impacts for months or years). We use construal level theory to investigate how the way employees construe where work occurs-defined as work context construal-influences perceptions of harm and the ethical framing of risk-mitigating behaviors. We hypothesize that high-level (abstract) work context construals (vs. low-level, concrete ones) reduce perceptions of potential harm which, in turn, leads to framing risk-mitigating behaviors as less of an ethical obligation. Six studies-a correlational survey of aviation employees (Study 1), field experiments with offshore drilling employees (Study 2A) and health care workers (Study 2B), a preregistered experiment with nurses (Study 3), and two supplemental studies (Studies 4A/B)-support our hypotheses. We discuss implications of this research for understanding organizational failures, particularly in a world where technology increasingly enables employees to monitor complex and high-risk work occurring many miles away, or on the other side of the world. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations of close social connections with smoking and vaping: a population study in England.

Studies consistently demonstrate smoking is a socially contagious behaviour, but less is known about the influence of social connections on vaping. This study examined associations between having close social connections who smoke or vape and relevant smoking and vaping outcomes. This was a representative cross-sectional survey of adults (≥16y) in England. Participants (n=1,618) were asked how many people they discuss important matters with (i.e., close social connections) and how many of them smoke/vape. We tested associations between (i) smoking and (ii) vaping among close social connections and participants' own smoking and vaping status; harm perceptions of e-cigarettes (among current smokers); attempts and success in quitting smoking (among past-year smokers); and use of e-cigarettes as a smoking cessation aid (among past-year smokers who tried to quit). Adults with ≥1 close social connection who smoke were more likely than those with none to smoke themselves (32.8% vs. 9.4%; ORadj=7.23[95%CI 4.74-11.0]) and had an uncertain lower likelihood to quit (12.2% vs. 19.8%; ORadj=0.46[0.17-1.23]). Those with ≥1 close social connection who vape were more likely than those with none to vape themselves (29.6% vs. 6.3%; ORadj=5.16[3.15-8.43]) and to use e-cigarettes in their most recent attempt to quit (57.0% vs. 27.9%; ORadj=18.0[1.80-181]), and had an uncertain higher likelihood to perceive e-cigarettes as less harmful than cigarettes (30.8% vs. 12.2%; ORadj=2.37[0.82-6.90]). In England, we replicated well-established associations with smoking and found similar evidence for vaping. People were much more likely to vape and to use e-cigarettes to quit smoking if they had close social connections who vaped. The cross-sectional design means it is not clear whether smoking/vaping among close social connections influences people to smoke/vape themselves, or whether people who smoke/vape select to form close social connections with others who similarly smoke/vape. Further research is required to establish causality. If the associations we observed are causal, interventions that encourage smokers to switch to vaping may have positive spillover effects on social connections' perceptions of e-cigarettes and use of these products to support smoking cessation.

Abstract A077: Chemical hair relaxer use and chemicals of concern in select hair relaxer products in two counties in Kenya: An analysis of inequities in environmental exposures from personal care products

Abstract Despite the widespread use of hair products, including chemical relaxers, little is known about the prevalence and patterns of use in populations outside the United States. Furthermore, there is emerging interest in the investigation of these products as key sources of exposure to chemicals of concern (CoCs), some of which may be associated with breast cancer. This study aimed to examine the prevalence and patterns of use of chemical relaxers among women in Embu and Nakuru Counties in Kenya, along with addressing key knowledge gaps about hair product use, practices, and perceptions of use. Additionally, we aimed to assess the presence of CoCs by examining product labels of selected relaxers widely used by women in these counties, where breast cancer incidence rates are increasing and concern about exposure to toxic chemicals in hair products is high. A total of 746 women aged 15-50 years enrolled in a questionnaire-based study, which ascertained sociodemographics, ever and current use of chemical relaxers, and perceptions of harm around hair product use. Multivariable-adjusted regression models were used to evaluate associations between participants’ sociodemographic characteristics and perceptions of hair product use in relation to the use of relaxers. Based on respondents’ responses, we purchased 22 commonly used hair relaxers in the target counties and recorded label information (including the ingredient lists). To identify CoCs, we cross-checked the lists of ingredients against the Campaign for Safe Cosmetics (CSC) Red List and European Union (EU) Prohibited/Restricted Substances Annex II and III, Regulation 1223/2009. Nearly 60% of participants reported ever use of chemical relaxers, with a little over one-third (35.7%) reporting current use of these products. On average, participants reported moderate-to-high levels of concern about exposures and general health effects from using hair products, and relatively high levels of perceived risk of breast cancer related to product use. We found that all 22 relaxers evaluated listed ≥1 CoCs in the products’ ingredients list. We documented 27 CoCs in total: 6 (23.08%) are categorized as Tier 1 (do not use CoCs for everyone) per the CSC Red List and 4 (14.81%) are prohibited substances per the EU Annex II of Regulation. This study contributes to a growing body of literature documenting CoCs listed on cosmetics labels, particularly products that are disproportionately used among Black and African ancestry populations globally. Further, this study justifies the need for increased public awareness of potentially harmful chemicals in hair products marketed and sold in Kenya. Improving the understanding of patterns of use of specific products and their chemical ingredients – which may be hormone disruptors and/or carcinogens – and exploring the role of environmental health literacy on product use is critical for developing interventions to reduce potentially harmful exposures found in these products. Citation Format: Nia C. Jenkins, Amber Rockson, Alexis Schaefer, Dustin T. Dunkin, Dede K. Teteh-Brooks, Mary Beth Terry, Jasmine A. McDonald, Beatrice Irungu, Esther Matu, Cecilia Kimani, Teresa Olisa, Adiba Ashrafi, Adana A.M. Llanos. Chemical hair relaxer use and chemicals of concern in select hair relaxer products in two counties in Kenya: An analysis of inequities in environmental exposures from personal care products [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A077.

Changes in the harm perceptions of different types of tobacco products for youth and adults: Waves 1–5 of the population assessment of tobacco and health (PATH) study, 2013–2019

IntroductionTobacco harm perceptions are associated with tobacco use for both youth and adults, but it is unknown how these harm perceptions have changed over time in a changing tobacco product landscape. MethodsData from Waves 1–5 of the Population Assessment of Tobacco and Health (PATH) Study were analyzed to examine perceptions of harm of eight non-cigarette tobacco products compared to cigarettes. Perceptions of harm were assessed with the questions, “Is smoking/using [product] less harmful, about the same, or more harmful than smoking cigarettes?”. ResultsThe share of participants who perceived non-cigarette combustible products as posing similar harm to cigarettes increased over time, while the share of participants who perceived non-combustible products as less harmful than cigarettes decreased over time. ConclusionsTobacco harm perceptions are changing over time, along with the tobacco product marketplace and regulatory environment.

Patterns and perceptions of vaping among adults living in social housing: a representative survey in Great Britain, 2023

BackgroundVaping products are effective for helping people to stop smoking and may therefore offer a potential means to reduce high rates of smoking in socioeconomically disadvantaged groups. This study aimed to examine current patterns and perceptions of vaping among people living in social housing in Great Britain compared with those living in other housing types.MethodsData were from the Smoking Toolkit Study; a nationally-representative survey conducted in 2023 (n = 23,245). Logistic regression tested cross-sectional associations between living in social (vs. other) housing and current vaping among adults; vaping frequency, device type, nicotine concentration, and source of purchase among current vapers; use of vaping products as a smoking cessation aid among past-year smokers who tried to quit; and harm perceptions of vaping products relative to cigarettes among current smokers.ResultsCurrent vaping prevalence was twice as high among adults living in social housing (19.4%) compared with those in other housing types (10.4%; OR = 2.07, 95%CI = 1.84–2.33). This was partly explained by differences in sociodemographic characteristics and smoking status; after adjustment, the odds of being a current vaper were 33% higher (ORadj=1.33, 95%CI = 1.14–1.54). Among vapers, there were no notable differences by housing tenure in vaping frequency, main device type used, usual nicotine concentration, usual source of purchase, or use as a smoking cessation aid. However, current smokers living in social housing were more likely to think vaping is more harmful than cigarettes (31.6% vs. 21.8%; ORadj=1.61, 95%CI = 1.30–1.99).ConclusionsIn Great Britain, adults who live in social housing are more likely to vape than those who live in other housing types, even after accounting for their younger age and higher smoking rates. However, misperceptions about the relative harms of vaping products and tobacco are common among smokers living in social housing. Interventions addressing these misperceptions could help encourage more people living in social housing to switch from smoking to vaping and reduce smoking-related health inequalities.Pre-registrationThe study protocol and analysis plan were pre-registered on Open Science Framework (https://osf.io/n3mvs/).

General practitioners’ risk literacy and real-world prescribing of potentially hazardous drugs: a cross-sectional study

BackgroundOveruse of medical care is a pervasive problem. Studies using hypothetical scenarios suggest that physicians’ risk literacy influences medical decisions; real-world correlations, however, are lacking. We sought to determine the...

Diversion or death? The moral framework shaping bifurcated punishments for drug offences in Indonesia

Background As the UN urges states to move from harsh punishments for drug offences towards treatment programmes, Indonesia has adopted a bifurcated penal policy. Most of those convicted are sentenced to imprisonment or death, but some ‘minor’ offenders are diverted to drug treatment centres. We explore the moralities that shape drug policy, justice professionals’ interpretation and application of laws and policies, and judgements about who is deserving of diversion. Methods We draw on experiences and perceptions of 136 Indonesian criminal justice professionals, through in-depth qualitative interviewing and focus groups, to reveal the moral landscapes shaping policy and practice. Results Justice narratives blur penal concerns with moral judgments about drug offending, with normative responses shaping punishments in law and practice. While there is some compassion for ‘minor’ drug offenders, driving rationales for diversion, drug traffickers are regarded as morally deserving of prison and capital punishment, with traditionalist perceptions of harm amplified by a purgative rationale. Conclusion This article highlights the analytical potential of moralities such as ‘compassion’ and ‘traditionalism’ in criminal justice research and policy in Southeast Asia. Understanding the formation and navigation of these normative values may assist in challenging harsh penal policy in Indonesia and the wider region.

Perceptions of Harm and Addictiveness for Nicotine Products, THC e-Cigarettes, and e-Cigarettes with Other Ingredients Among Adolescents, Young Adults, and Adults

Background Perceptions of health harms and addictiveness related to nicotine products, THC e-cigarettes, and e-cigarettes with other ingredients are an important predictor of use. This study examined differences in perceived harm and addiction across such products among adolescents, young adults, and adults. Methods We conducted a cross-sectional survey (N = 6,131, ages 13–40 years old) in which participants reported perceived harm and addictiveness for 11 products (cigarettes, disposable nicotine e-cigarettes, pod-based nicotine e-cigarettes, other nicotine e-cigarettes, THC e-cigarettes, e-cigarettes with other ingredients, nicotine pouches, nicotine lozenges, nicotine gums, nicotine tablets, nicotine toothpicks). We applied adjusted regression models and conducted pairwise comparisons between age groups (13–17, 18–20, 21–25, and 26–40) and product use status (never, ever, and past-30-day use), adjusting for gender, race/ethnicity, sexual orientation, and financial comfort. Results Overall, participants in younger age groups perceived products to be more harmful and addictive than those in older age groups, with the exception of e-cigarettes with other ingredients. For all products, participants who never used perceived each product to be more harmful than those who ever used. For all products, participants who used the products in the past 30-days had lower perceived harm and addictiveness compared to never and ever use. Certain sociodemographic groups, such as people who identify as LGBTQ+, Non-Hispanic Black, or Hispanic, had lower perceived harm and addictiveness for most products. Discussion Efforts should be made to educate all age groups and minoritized groups on harms and addictiveness of all nicotine products, THC e-cigarettes, and e-cigarettes with other ingredients.