Nicotine - Misperceptions, Misinformation, or Disinformation: Difference between revisions

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='''Multi-National'''=

==Consumers==

===2022: [https://pubmed.ncbi.nlm.nih.gov/35368082/ Do smokers' perceptions of the harmfulness of nicotine replacement therapy and nicotine vaping products as compared to cigarettes influence their use as an aid for smoking cessation? Findings from the ITC Four Country Smoking and Vaping Surveys]===

*We analyzed data from 1,315 current daily smokers (10+ cigarettes per day) who were recruited at Wave 1 (2016), and who reported making a quit attempt by Wave 2 (2018) of the International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England, and the United States.

*Consistent with past studies,our findings confirm that harm perceptions influence nicotine product use, with accurate perceptions associated with greater likelihood of use as a smoking cessation aid, whereas inaccurate perceptions appear to deter their use for this purpose.

===2022: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac088/6562888 Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)]===

*Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained.

===2021: [https://bmjopen.bmj.com/content/11/9/e045445 Effects of brief exposure to misinformation about e-cigarette harms on twitter: a randomised controlled experiment]===

*This is the first study to explore the effect of exposure to misinformation about e-cigarette harms on Twitter, showing that after brief exposure to tweets that e-cigarettes are as or more harmful than smoking, current smokers may be deterred from using e-cigarettes (measured with intention to purchase e-cigarettes) as a harm reduction strategy. They are also more likely to wrongly believe that e-cigarettes are more harmful than regular cigarettes.  

*The increasing trends of misperceptions about the relative harms of e-cigarettes compared with regular cigarettes are important for public health because perceived harms of e-cigarettes are associated with smokers' willingness to use e-cigarettes6 as a harm reduction strategy.

===2020: [https://www.emerald.com/insight/content/doi/10.1108/DAT-04-2020-0022/full/html Perceptions of nicotine in current and former users of tobacco and tobacco harm reduction products from seven countries]===

*We observed that the majority of current and previous product users estimated the harmfulness of nicotine and cigarettes alike. This has led to the misled conclusion that nicotine is responsible for the detrimental effects related to combustible tobacco consumption, even though science has found only very limited and often inconclusive evidence to date that nicotine is any more harmful than other legally consumed stimulants.

*Contradictory statements by leading researchers supported by renowned funding agencies and misreporting by the media may further public confusion as people have stated they use the media as a source of health information.

===2020: [https://www.emerald.com/insight/content/doi/10.1108/DAT-02-2020-0007/full/html Tobacco harm reduction in the 21st century]===

*The misperception of the risks of these products results in smokers rejecting them, misperceptions that arise from inaccurate information and sensational media headlines. Public health officials are misinformed by these sources as well...

*These barriers will need to be addressed if tobacco harm reduction is to make the maximum impact on the tobacco endemic.

===2020: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296947/ Inequalities, harm reduction and non-combustible nicotine products: a meta-ethnography of qualitative evidence]===

**lack of a perceived advantage of alternative products over smoking;  

**and a perceived lack of information about relative harms of NCNP compared to smoking.

==Health Care==

===2013: [https://www.emerald.com/insight/content/doi/10.1108/DAT-02-2013-0010/full/html Survey of GPs' understanding of tobacco and nicotine products]===

==Consumers==

===2022: [https://pubmed.ncbi.nlm.nih.gov/35368082/ Do smokers' perceptions of the harmfulness of nicotine replacement therapy and nicotine vaping products as compared to cigarettes influence their use as an aid for smoking cessation? Findings from the ITC Four Country Smoking and Vaping Surveys]===

*We analyzed data from 1,315 current daily smokers (10+ cigarettes per day) who were recruited at Wave 1 (2016), and who reported making a quit attempt by Wave 2 (2018) of the International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England, and the United States.

*Consistent with past studies,our findings confirm that harm perceptions influence nicotine product use, with accurate perceptions associated with greater likelihood of use as a smoking cessation aid, whereas inaccurate perceptions appear to deter their use for this purpose.

===2022: [https://stories.uq.edu.au/medicine/2020/clarifying-australia-s-youth-vaping-figures/index.html Clarifying Australia’s youth vaping figures]===

*The incorrect reporting of Australia’s purported ‘youth vaping epidemic’ has been used to argue for even tougher restrictions on access to nicotine vaping products. We should be restricting access to the nicotine product that causes the greatest harm in Australia, tobacco cigarettes. Cigarettes are still used by 2.9 million Australians who easily access them at retail outlets, despite being the leading preventable cause of disease burden.

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==Consumers==

===2022: [https://pubmed.ncbi.nlm.nih.gov/35368082/ Do smokers' perceptions of the harmfulness of nicotine replacement therapy and nicotine vaping products as compared to cigarettes influence their use as an aid for smoking cessation? Findings from the ITC Four Country Smoking and Vaping Surveys]===

*We analyzed data from 1,315 current daily smokers (10+ cigarettes per day) who were recruited at Wave 1 (2016), and who reported making a quit attempt by Wave 2 (2018) of the International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England, and the United States.

*Consistent with past studies,our findings confirm that harm perceptions influence nicotine product use, with accurate perceptions associated with greater likelihood of use as a smoking cessation aid, whereas inaccurate perceptions appear to deter their use for this purpose.

===2022: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac088/6562888 Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)]===

*Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained.

='''France'''=

*Article: [https://fr.vapingpost.com/80-des-francais-pensent-que-la-vape-donne-le-cancer/ 80% of French people believe that vaping causes cancer]

='''Germany'''=

==Health Care==

===2009: [https://academic.oup.com/ntr/article-abstract/11/1/92/1042977 Medical students lack basic knowledge about smoking: Findings from two European medical schools]===

*We observed that the majority of current and previous product users estimated the harmfulness of nicotine and cigarettes alike. This has led to the misled conclusion that nicotine is responsible for the detrimental effects related to combustible tobacco consumption, even though science has found only very limited and often inconclusive evidence to date that nicotine is any more harmful than other legally consumed stimulants.

*Contradictory statements by leading researchers supported by renowned funding agencies and misreporting by the media may further public confusion as people have stated they use the media as a source of health information.

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*We observed that the majority of current and previous product users estimated the harmfulness of nicotine and cigarettes alike. This has led to the misled conclusion that nicotine is responsible for the detrimental effects related to combustible tobacco consumption, even though science has found only very limited and often inconclusive evidence to date that nicotine is any more harmful than other legally consumed stimulants.

*Contradictory statements by leading researchers supported by renowned funding agencies and misreporting by the media may further public confusion as people have stated they use the media as a source of health information.

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*We observed that the majority of current and previous product users estimated the harmfulness of nicotine and cigarettes alike. This has led to the misled conclusion that nicotine is responsible for the detrimental effects related to combustible tobacco consumption, even though science has found only very limited and often inconclusive evidence to date that nicotine is any more harmful than other legally consumed stimulants.

*Contradictory statements by leading researchers supported by renowned funding agencies and misreporting by the media may further public confusion as people have stated they use the media as a source of health information.

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==Health Care==

===2017: [https://pubmed.ncbi.nlm.nih.gov/28235068/ Lung cancer specialist physicians' attitudes towards e-cigarettes: A nationwide survey]===

*Most respondents believed that e-cigarettes are not safer than conventional tobacco cigarettes (75.7%) or smokeless tobacco (83.2%), and feared that discussing e-cigarettes with the patients would encourage use (65.4%). They did not consider it a smoking cessation treatment (78.3%), and thus would not recommend it to smokers who do not want to quit (82.2%) or who failed to quit with conventional smoking cessation treatment (74.1%).

*Most learned about e-cigarettes from media and advertisements, or conversation with patients rather than through professional scientific resources, and reported discomfort when discussing e-cigarette with patients.

='''Netherlands (Holland)'''=

*Misunderstands “dual-use”.

*Asserts a “gateway effect” but there is more likely to be a diversion away from smoking.

='''Norway'''=

*Among participants, 40.9% disagreed (“rather disagree” or “totally disagree”) that e-cigarettes are less harmful than conventional cigarettes.

*We have observed that only 21% of physicians get information about e-cigarettes from scientific articles. Most participants learned about e-cigarettes from non-scientific sources such as news stories or storefronts. Information obtained from such sources are not scientifically verified and might be biased. This poses a threat that education and guidance about e-cigarettes delivered by physicians is not based on evidence. Similar results were observed among healthcare providers’ in the US where the most frequently reported source of knowledge about e-cigarettes were patients (62%) or news stories (39%).

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==Consumers==

===2020: [https://www.emerald.com/insight/content/doi/10.1108/DAT-04-2020-0022/full/html Perceptions of nicotine in current and former users of tobacco and tobacco harm reduction products from seven countries]===

*We observed that the majority of current and previous product users estimated the harmfulness of nicotine and cigarettes alike. This has led to the misled conclusion that nicotine is responsible for the detrimental effects related to combustible tobacco consumption, even though science has found only very limited and often inconclusive evidence to date that nicotine is any more harmful than other legally consumed stimulants.

*Contradictory statements by leading researchers supported by renowned funding agencies and misreporting by the media may further public confusion as people have stated they use the media as a source of health information.

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===2010: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928193/ Harm perception among Swedish daily smokers regarding nicotine, NRT-products and Swedish Snus]===

*A majority, 59% of the answers to the question about harmfulness of NRT-products, and 75% of the answers about harmfulness of Snus, were inconsistent with the scientific evidence by demonstrating exaggerated perceptions of harmfulness. The strongest predictor of consistent answers was the perception of the harmfulness of nicotine.

==Health Care==

===2013: [https://www.emerald.com/insight/content/doi/10.1108/DAT-02-2013-0010/full/html Survey of GPs' understanding of tobacco and nicotine products]===

**...less than half believe that long-term nicotine replacement therapy (NRT) is preferable to smoking (31% UK, 48% Sweden).

**Many (44% UK, 56% Sweden) also wrongly believe that nicotine in tobacco products is associated with cancer, while 15% in the UK and 22% in Sweden believe the same for pharmaceutical nicotine.

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==Consumers==

===2022: [https://pubmed.ncbi.nlm.nih.gov/35368082/ Do smokers' perceptions of the harmfulness of nicotine replacement therapy and nicotine vaping products as compared to cigarettes influence their use as an aid for smoking cessation? Findings from the ITC Four Country Smoking and Vaping Surveys]===

*We analyzed data from 1,315 current daily smokers (10+ cigarettes per day) who were recruited at Wave 1 (2016), and who reported making a quit attempt by Wave 2 (2018) of the International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England, and the United States.

*Consistent with past studies,our findings confirm that harm perceptions influence nicotine product use, with accurate perceptions associated with greater likelihood of use as a smoking cessation aid, whereas inaccurate perceptions appear to deter their use for this purpose.

===2022: [https://nrgppi.org/recent-research/what-are-people-s-views-about-the-risks-of-vaping What are people’s views about the risks of vaping? Findings from conversations with the public.]===

**Increasing discussions and education in school about ‘negative consequences of vaping’

**Desensitisation to public health messaging about the reduced harm of vaping relative to smoking

===2022: [https://demos.co.uk/wp-content/uploads/2022/05/myths-and-misinformation.pdf Myths and Misinformation: Mapping the barriers to smoking cessation and the uptake of nicotine alternatives]===

*...with 93% of Brits overestimating the health risk of nicotine,...The over 60s and those from the lowest socio economic groups (C2DE) are the most likely to be misinformed...

*Our research has also revealed the scale of misunderstanding around vaping, with 90% of Brits’ responses ‘broadly incorrect’ about its harm compared to tobacco cigarettes; this despite public health evidence asserting that vaping is unlikely to exceed 5% of the harm that comes from smoking cigarettes.

===2022: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac088/6562888 Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)]===

*Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained.

===2022: [https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1081366/khan-review-making-smoking-obsolete.pdf The Khan review Making smoking obsolete]===

*However, there is lots of confusion, even misinformation, about vaping. The most common relates to its harm. I have spoken to the very best academics and scientists across the country and internationally. They all told me that vaping is far less harmful than smoking.

*In cigarettes, we know that it is not the nicotine that kills you but the other thousands of toxic chemicals such as tar and carbon monoxide. Vapes give smokers the nicotine they crave but protect them from the toxins they would inhale from a cigarette.

===2021: [https://ash.org.uk/wp-content/uploads/2021/06/Use-of-e-cigarettes-vapes-among-adults-in-Great-Britain-2021.pdf Use of e-cigarettes (vapes) among adults in  Great Britain]===

*The main reason given by current smokers for vaping is to cut down (26%) then to help them quit (17%) and to prevent relapse (14%).

*Nearly a third of smokers incorrectly believe vaping is more or equally as harmful as smoking (32% compared to 34% in 2020).  

===2021: Video: [https://vimeo.com/649054668 Depression causes vaping!]===

*This is the first study to explore the effect of exposure to misinformation about e-cigarette harms on Twitter, showing that after brief exposure to tweets that e-cigarettes are as or more harmful than smoking, current smokers may be deterred from using e-cigarettes (measured with intention to purchase e-cigarettes) as a harm reduction strategy. They are also more likely to wrongly believe that e-cigarettes are more harmful than regular cigarettes.  

*The increasing trends of misperceptions about the relative harms of e-cigarettes compared with regular cigarettes are important for public health because perceived harms of e-cigarettes are associated with smokers' willingness to use e-cigarettes6 as a harm reduction strategy.

===2020: [https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01565-2 Association between changes in harm perceptions and e-cigarette use among current tobacco smokers in England: a time series analysis]===

*Between 2014 and 2019 in England, at the population level, monthly changes in the prevalence of accurate harm perceptions among current tobacco smokers were strongly associated with changes in e-cigarette use.

*For every 1% decrease in the mean prevalence of current tobacco smokers who endorsed the belief that e-cigarettes are less harmful than combustible cigarettes, the mean prevalence of e-cigarette use decreased by 0.48%

===2020: [https://www.emerald.com/insight/content/doi/10.1108/DAT-04-2020-0022/full/html Perceptions of nicotine in current and former users of tobacco and tobacco harm reduction products from seven countries]===

*We observed that the majority of current and previous product users estimated the harmfulness of nicotine and cigarettes alike. This has led to the misled conclusion that nicotine is responsible for the detrimental effects related to combustible tobacco consumption, even though science has found only very limited and often inconclusive evidence to date that nicotine is any more harmful than other legally consumed stimulants.

*Contradictory statements by leading researchers supported by renowned funding agencies and misreporting by the media may further public confusion as people have stated they use the media as a source of health information.

===2019: Video: [https://www.youtube.com/watch?v=c6_4RUTMFuE John Britton takes anti-vaping media to task]===

*E-cigarette Summit 2019

*John Britton, respiratory physician and Director of the UK Centre for Tobacco and Alcohol Studies at the University of Nottingham tells media and medical journals that when they publish hyperbolic stories about the harms of vaping they are sending people back to smoking and early death. Full video of Britton's E-cigarette Summit presentation available at vimeo.com/373905893

===2019: [https://onlinelibrary.wiley.com/doi/10.1111/add.14502 Harm perceptions of e-cigarettes and other nicotine products in a UK sample]===

**"Lead researcher Dr Leonie Brose, from the Institute of Psychiatry, Psychology & Neuroscience, said 'Tobacco cigarettes kill over half of those who smoke long-term, yet very few people know that nicotine is not the direct cause of smoking-related death and disease. We found those people who think nicotine is to blame for harms from smoking are more likely to think e-cigarettes and NRT are just as bad as smoking.'"

**"Knowledge about nicotine was particularly poor, with nearly nine out of ten misattributing a greater portion of the risk in smoking to nicotine, and nearly four out of ten wrongly believing nicotine is what causes cancer from smoking."

===2015: [https://www.rsph.org.uk/about-us/news/nicotine--no-more-harmful-to-health-than-caffeine-.html Nicotine “no more harmful to health than caffeine”]===

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==Consumers==

===2022: [https://pubmed.ncbi.nlm.nih.gov/36482754/ Unintended Consequences: Testing the Effects of Adolescent-Targeted Anti-Vaping Media upon Adult Smokers]===

*Sensationalized youth-oriented anti-vaping messages may have unintended public health consequences upon adult audiences.

*Exposure to the PSA resulted in overall more negative expectancies about e-cigarettes, as well as increased perceived harmfulness and reduced effectiveness of e-cigarettes for smoking cessation. Findings showed that these PSAs could deter adult smokers from utilization of e-cigarettes as a smoking cessation or harm reduction strategy.

===2022: [https://www.ajpmonline.org/article/S0749-3797(22)00177-5/fulltext Relative Harm Perceptions of E-Cigarettes Versus Cigarettes, U.S. Adults, 2018–2020]===

**The main finding that people started smoking cigarettes when they thought e-cigarettes were more harmful should be a wake-up to public health officials and doctors...

**The new study showed a sharp change in public perception of e-cigarettes following media coverage of cases of users who presented to emergency rooms with mysterious lung symptoms (EVALI) in 2019.  

===2022: [https://pubmed.ncbi.nlm.nih.gov/35368082/ Do smokers' perceptions of the harmfulness of nicotine replacement therapy and nicotine vaping products as compared to cigarettes influence their use as an aid for smoking cessation? Findings from the ITC Four Country Smoking and Vaping Surveys]===

*We analyzed data from 1,315 current daily smokers (10+ cigarettes per day) who were recruited at Wave 1 (2016), and who reported making a quit attempt by Wave 2 (2018) of the International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England, and the United States.

*Consistent with past studies,our findings confirm that harm perceptions influence nicotine product use, with accurate perceptions associated with greater likelihood of use as a smoking cessation aid, whereas inaccurate perceptions appear to deter their use for this purpose.

===2022: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac088/6562888 Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)]===

*Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained.

===2022: [https://pubmed.ncbi.nlm.nih.gov/35385112/ Beliefs and Characteristics Associated With Believing Nicotine Causes Cancer: A Descriptive Analysis to Inform Corrective Message Content and Priority Audiences]===

*About 61.2% of smokers believe nicotine causes cancer or don't know.

*High perceived threat of tobacco may be overgeneralized to nicotine. High prevalence of the misperception among Non-Hispanic Black and low-income smokers is concerning, considering existing health disparities. Messaging should attempt to correct the misperception that nicotine causes cancer.

===2022: Audio: [https://news.wosu.org/show/all-sides-with-ann-fisher/2022-06-29/wellness-wednesday-mental-health-screenings-and-suicide-prevention Cliff Douglas on WOSU]===

*Misinformation, continuum of risk, etc.

===2022: [https://www.jaci-inpractice.org/article/S2213-2198(22)00584-0/pdf A Close Look at Vaping in Adolescents and Young Adults in the USA]===

*Public mistrust about ECs is exacerbated by the spread of misinformation and distortion of scientific truth.

*Although EC use by young non-smokers is a legitimate concern, known risks from vaping are often greatly exaggerated; common misconceptions about EC use and the evidence to refute these misconceptions have been summarized in Table 2

===2022: Opinion: [https://www.medpagetoday.com/opinion/second-opinions/99553 A Bold U.K. Plan to End the Smoking Epidemic]===

*Youth vaping is no longer an "epidemic." But these efforts, which too often inaccurately portray the risks of e-cigarettes, have led to significant public misunderstanding regarding the substantially lower health risks of e-cigarettes compared to combustible tobacco products. This, in turn, has impeded the promotion of tobacco harm reduction to the more than 30 million adults who still smoke.

*Nicotine causes dependency but does not itself cause the many diseases resulting from the inhalation of burned tobacco, a fact misunderstood by the majority of physicians...

===2022: [https://pubmed.ncbi.nlm.nih.gov/35800020/ In vivo Experience With NRT to Increase Adherence and Smoking Abstinence Among Individuals in the Criminal Legal System: Study Protocol for a Randomized Clinical Trial]===

*Nicotine replacement therapy (NRT) is a relatively effective and accessible smoking cessation aid; however, individuals frequently stop use of NRT early due to side effects and misperceptions about the products.  

*The in vivo group uses NRT in session and discusses perceptions and experiences of using NRT in real time...

===2022: [https://pubmed.ncbi.nlm.nih.gov/33608466/ Google shopping queries for vaping products, JUUL and IQOS during the E-cigarette, or Vaping, product use Associated Lung Injury (EVALI) outbreak]===

*Results: During the outbreak, vape shopping queries were 34% (95% CI 30% to 38%) lower than expected and JUUL shopping queries were 39% (95% CI 34% to 45%) lower than expected, translating into about 7.2 and 1.0 million fewer searches. IQOS shopping queries were 58% (95% prediction interval (PI): 34-87) higher than expected, translating into 35 000 more searches. Moreover, IQOS shopping queries reached a historic high the week they were discussed as a potentially safe alternative to vaping (the week of 29 September 2019), when they were 382% (95% PI: 219-881) above expected rates for the week.

*Note from the Safer Nicotine Wiki team: EVALI during the time of this study was being incorrectly blamed on nicotine vapor products. IQOS is a heated tobacco product, not a traditional vapor product.

===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949332/ Perceptions of E-cigarettes among adults in treatment for opioid use disorder]===

*Nonetheless, a sizable proportion of participants in our sample rated e-cigarettes as harmful and rated e-cigarettes as more or equivalently harmful as cigarettes. Our findings align with recent work in the general population demonstrating increases in perceived harm of e-cigarettes following EVALI

===2021: [https://academic.oup.com/ntr/article-abstract/24/6/855/6440299 Associations Between Nicotine Knowledge and Smoking Cessation Behaviors Among US Adults Who Smoke]===

*The public’s inaccurate perception worsened following a 2019 vaping-associated acute pulmonary disease outbreak [EVALI]...research attributed the illness to vitamin E acetate, an adulterant in illicit tetrahydrocannabinol (THC) vaping devices...Yet, after the outbreak, two thirds of respondents to a poll related the lung disease deaths to use of “e-cigarettes such as JUUL.” Only 28% related the deaths to use of “marijuana or THC e-cigarettes.”

* In a recent survey of physicians, 80% strongly, but incorrectly, agreed that nicotine causes cancer, cardiovascular disease, and chronic obstructive pulmonary disease.

===2021: Video: [https://vimeo.com/649054668 Depression causes vaping!]===

*In this talk [https://www.e-cigarette-summit.co.uk/seminar/depression-causes-vaping/ Professor Notley] will discuss the latest evidence exploring associations between nicotine use and common mental health conditions, including depression.  

*Interpretive assumptions will be drawn out, including inappropriate claims of causal relationships between vaping and depression.  

===2021: [https://bmjopen.bmj.com/content/11/9/e045445 Effects of brief exposure to misinformation about e-cigarette harms on twitter: a randomised controlled experiment]===

*This is the first study to explore the effect of exposure to misinformation about e-cigarette harms on Twitter, showing that after brief exposure to tweets that e-cigarettes are as or more harmful than smoking, current smokers may be deterred from using e-cigarettes (measured with intention to purchase e-cigarettes) as a harm reduction strategy. They are also more likely to wrongly believe that e-cigarettes are more harmful than regular cigarettes.  

*The increasing trends of misperceptions about the relative harms of e-cigarettes compared with regular cigarettes are important for public health because perceived harms of e-cigarettes are associated with smokers' willingness to use e-cigarettes6 as a harm reduction strategy.

===2021: [https://academic.oup.com/milmed/article/186/1-2/24/5909705 E-Cigarette Use and Perceptions Among Veterans Receiving Outpatient Treatment in Veterans Affairs Substance Use and Mental Health Clinics]===

*36% of study participants falsely believed vaping was as harmful as smoking.

===2021: Opinion Michael Madden, MD: [https://www.newsweek.com/misinformation-threatens-efforts-reduce-tobacco-harm-opinion-1616650 Misinformation Threatens Efforts to Reduce Tobacco Harm ]===

*The findings of this study emphasise the urgent need to accurately communicate the reduced relative risk of e-cigarettes compared to continued cigarette smoking and clearly differentiate absolute and relative harms.

===2020: [https://www.emerald.com/insight/content/doi/10.1108/DAT-04-2020-0022/full/html Perceptions of nicotine in current and former users of tobacco and tobacco harm reduction products from seven countries]===

*In 2 nationally representative multiyear cross-sectional surveys of US adults, the proportion who perceived e-cigarettes to be as harmful as or more harmful than cigarettes increased substantially from 2012 to 2017.

*Given the demonstration by previous studies that perception of risk plays a critical role in decisions to use tobacco, our results imply that at least some smokers may have been deterred from using or switching to e-cigarettes due to the growing perception that e-cigarettes are equally harmful or more harmful than cigarettes.

===2019: [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2755664 Perceived Comparative Harm of Cigarettes and Electronic Nicotine Delivery Systems]===

*Between 2017 and 2018, the percentage of US adults who perceived ENDS to be less harmful than cigarettes decreased, while there was an increase in the proportion of US adults who perceived ENDS to be more harmful or much more harmful.

===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939783/ Misperceptions of Nicotine and Nicotine Reduction: The Importance of Public Education to Maximize the Benefits of a Nicotine Reduction Standard]===

*Recent population-level data highlight that 49%–80% of US adults incorrectly believe that nicotine is responsible for most of the cancer caused by smoking.

*Additionally, between 23% and 43% of young adults responded “don’t know” to items on nicotine perceptions and more than 50% of respondents, including past 30-day tobacco users, perceived nicotine gum and patch to be as harmful or more harmful than cigarettes to overall health and specifically, to causing cancer or heart attack.

===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756180/ Impact of Brief Nicotine Messaging on Nicotine-Related Beliefs in a U.S. Sample]===

*Following exposure, nicotine education participants reported fewer false beliefs about nicotine, nicotine replacement therapies, e-cigarettes, and reduced nicotine cigarettes compared with the control conditions.  

*Nicotine messaging doubled the probability of a correct response (false, 78.3% vs 36.8%) to nicotine is a cause of cancer and dramatically reduced the probability of responding don’t know to this item (5.3% vs 26.0%).

===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939783/ Misperceptions of Nicotine and Nicotine Reduction: The Importance of Public Education to Maximize the Benefits of a Nicotine Reduction Standard]===

*Given these common misperceptions about nicotine, a low nicotine product standard has potential to further confuse consumers about tobacco product risks in the absence of public education efforts.

===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939779/ Reducing Nicotine Without Misleading the Public: Descriptions of Cigarette Nicotine Level and Accuracy of Perceptions About Nicotine Content, Addictiveness, and Risk]===

*Stating that 95% of nicotine would be removed more accurately conveyed the nicotine content and addictiveness of VLNC cigarettes. However, descriptions that better conveyed nicotine content and addictiveness misled people about cancer risk.

===2017: [https://pubmed.ncbi.nlm.nih.gov/28341303/ Changing Perceptions of Harm of E-Cigarettes Among U.S. Adults, 2012-2015]===

*Higher risk perceptions of e-cigarettes could deter current smokers from using e-cigarettes as a cessation aid of smoking combustible cigarettes and preventing a potential public health benefit.

*The finding that the higher percentages of adults, including current smokers, misperceived e-cigarettes to be equally or more harmful than cigarettes between 2012 and 2015 may be stemming from misinformed media stories

===2017: [https://www.researchgate.net/publication/316456914_Nicotine_and_E-cigarette_Beliefs_and_Policy_Support_among_US_Smokers_and_Nonsmokers Nicotine and E-cigarette Beliefs and Policy Support among US Smokers and Nonsmokers]===

*Whereas perception of harm associated with e-cigarettes was significantly lower for smokers than for nonsmokers, most respondents (80%), regardless of current smoking status, believed that nicotine is the primary disease-causing agent in tobacco products (nicotine harm perception).

*In multivariable analyses, believing that e-cigarettes were more harmful was associated with greater support for bans on indoor e-cigarette use, use in cars with children present, and a ban on e-cigarette sales to minors. As beliefs about e-cigarette harm increased, there was less support for a differentiated tax structure for e-cigarettes relative to combustible cigarettes.

===2017: Opinion: [https://thehill.com/opinion/healthcare/360111-america-needs-a-candid-smoking-control-champion/ America needs a candid smoking control champion]===

*But current and future smokers, who are the ones in immediate peril, must also be able to make decisions based on truthful information about how new smokeless products differ in their relative harms from smoked tobacco.  

*A purist stance misleads the public into thinking that all tobacco products are equally harmful.

===2017: Article: [https://conscienhealth.org/2017/11/fda-going-nicotine-tobacco/ Guest Post: Where Is FDA Going with Nicotine and Tobacco?]===

*The FDA faces many challenges to realize this future. But perhaps the greatest obstacle, based on FDA’s own data, is that upwards of 80% of smokers believe that nicotine itself is the primary ingredient that causes cancer. We hope that FDA uses its bully pulpit and other communication channels to correct the record; its bold plan will be even harder to execute if they do not.

===2016: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328980/#FN1 U.S. adults' addiction and harm beliefs about nicotine and low nicotine cigarettes]===

*Incorrectly believing that nicotine causes cancer could discourage smokers from switching to safer nicotine-containing alternatives, and could lead nonsmokers to experiment with low nicotine tobacco products, believing that cancer risk would be reduced.

===2011: [https://pubmed.ncbi.nlm.nih.gov/21371825/ Providing accurate safety information may increase a smoker's willingness to use nicotine replacement therapy as part of a quit attempt]===

*93% of smokers did not know that smoking while wearing the nicotine patch does not cause heart attacks; 76% that nicotine gum/lozenge are not as addictive as cigarettes; and 69% that NRT products are not as dangerous as cigarettes. Over half of the smokers with misperceptions reported that they would be more likely to use NRT (nicotine replacement therapy) to help them quit smoking if they were exposed to information correcting their concerns

===2008: [https://pubmed.ncbi.nlm.nih.gov/18855827/ Perceived safety and efficacy of nicotine replacement therapies among US smokers and ex-smokers: relationship with use and compliance]===

*Two-thirds (66%) of respondents either agreed that 'Stop-smoking products with nicotine are just as harmful as cigarettes' or were unsure whether the statement was true.

<br>

==Health Care==

===2022: [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2791164 Communication Between US Physicians and Patients Regarding Electronic Cigarette Use]===

*It is critical to address physician nicotine misperceptions and to correct misperceptions regarding the relative harm of various tobacco products as more modified-risk tobacco products may be introduced through an FDA authorization process.

*[https://twitter.com/CrisDelnevo/status/1514999731474288643 Twitter thread by Cristine D. Delnevo, PhD, MPH about the study]

===2021: [https://www.mdpi.com/1660-4601/18/14/7713/htm Persistent Misperceptions about Nicotine among US Physicians: Results from a Randomized Survey Experiment]===

*Question wording is important when measuring physicians’ beliefs about nicotine; however, even after accounting for question version, misperceptions about the direct health effects of nicotine were common and varied by sex and specialty.

===2021: [https://onlinelibrary.wiley.com/doi/10.1002/jdd.12788 Nicotine-related misperceptions among faculty and students at a Midwestern dental school]===

*Dental school faculty and students linked the risks of smoking tobacco to nicotine. Based on the results of this study, we feel our institution's curriculum should consider including information specific to nicotine in addition to tobacco in general.

===2020: [https://link.springer.com/article/10.1007/s11606-020-06172-8 Nicotine Risk Misperception Among US Physicians]===

*Rutgers Article: [https://www.rutgers.edu/news/rutgers-led-national-survey-uncovers-doctors-misconceptions-about-nicotine-risks Researchers say physicians need to understand accurate nicotine risks better to assist patients addicted to the most harmful tobacco products]

*Filter Article: [https://filtermag.org/doctors-nicotine-tobacco/ Majority of Surveyed Doctors Misattribute Tobacco Harms to Nicotine]

===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4111908/ Healthcare Providers’ Beliefs and Attitudes About Electronic Cigarettes and Preventive Counseling for Adolescent Patients]===

*The most frequently cited sources of information about e-cigarettes were patients, news stories, and advertisements, rather than professional sources.

===2007: [https://pubmed.ncbi.nlm.nih.gov/17558822/ Nurses' knowledge about the risk of light cigarettes and other tobacco "harm reduction" strategies]===

==Consumer==

===2022: [https://formative.jmir.org/2022/4/e26335 Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19: Qualitative Analysis of Twitter Content]===

<br>

===2021: Referring to: [https://www.nature.com/articles/s41415-021-3563-1 Erosive potential of commonly available vapes: a cause for concern?]===

==Media==

===2022: [https://stories.uq.edu.au/medicine/2020/clarifying-australia-s-youth-vaping-figures/index.html Clarifying Australia’s youth vaping figures]===

===2022: [https://theavm.org/accountability/our-outreach-to-the-new-york-times-on-their-slanted-reporting AVM: Our Outreach to the New York Times on Its Slanted Vaping Reporting]===

===2022: [https://theavm.org/accountability/reuters-packs-a-lot-of-slant-into-a-few-hundred-words-on-the-latest-fda-court-challenge AVM: Reuters Packs A Lot of Slant Into a Few Hundred Words On the Latest FDA Court Challenge]===

==Non-profits or Their Funders==

===2022: [https://filtermag.org/truth-initiative/?utm_source=twitter&utm_medium=social&utm_campaign=filter The Half-Truth Initiative: How an Anti-Smoking Group Lost Its Way]===

*“We’re not talking misinformation. We’re talking disinformation. This is willful misrepresentation of facts. It’s mind-blowing.”

===2022: [https://theavm.org/accountability/what-anti-vaping-activists-get-wrong-in-their-fda-letter AVM: What Anti-Vaping Activists Get Wrong In Their FDA Letter]===

===2021: Video: [https://vimeo.com/559881052 Are we risking the erosion of trust in Tobacco Control?]===

*Prof Mike Cummings presenting at E-Cigarette Summit 2021

*Successful public health campaigns rely on establishing and maintaining the public’s trust in the recommendations that are given.  This presentation highlights concerns that I have about the erosion of trust in tobacco control that appears to be happening because previously trusted public health officials are staking out policy positions that distort the truth about lower risk alternative nicotine products.

===2021: Truth Initiative's [https://truthinitiative.org/press/press-release/truth-launches-fake-vape-company-depression-stick-make-point Depression Sticks] Campaign===

===2022: [https://www.aspenideas.org/sessions/the-war-on-misinformation Aspen Ideas Festival 2022 - Misinformation]===

===2021: [https://www.sciencedirect.com/science/article/pii/S2352827321002251 Walking the party line: The growing role of political ideology in shaping health behavior in the United States]===

===2019: [https://twitter.com/TamarHaspel/status/1206581050727641088 Twitter thread by:Tamar Haspel - Guarding against her own biases]===

===2018: [https://jamesclear.com/why-facts-dont-change-minds Why Facts Don’t Change Our Minds]===

='''Suggestions to add to this page'''=

===2023: [https://pubmed.ncbi.nlm.nih.gov/37131244/ Identifying spin bias of nonsignificant findings in biomedical studies]===

===2023: [https://www.sciencedirect.com/science/article/pii/S0376871623000443 What drives public perceptions of e-cigarettes? A mixed-methods study exploring reasons behind adults’ perceptions of e-cigarettes in Northern England]===

===2023: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntad028/7078383 Youths’ Perceptions of Nicotine Harm and Associations With Product Use]===

===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9747677/ Challenges in communicating the benefits of switching from cigarettes to e-cigarettes: Responses from eight adult focus groups with varying smoking experience]===

===2022: [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01997-3/fulltext UK report underscores potential of e-cigarettes to reduce smoking harms]===

*"The Nicotine Vaping in England report suggests that health risks of vaping are often overstated, resulting in inaccurate risk perceptions that could deter people who use the most harmful product (cigarettes) from switching to less harmful product (e-cigarettes). According to representative surveys of young people (11–18 years) and adults (≥18 years) in England in 2021, 55°3% of young people and 65·9% of adult smokers and vapers in England mistakenly think that vaping is as harmful or more harmful than smoking.2 Such inaccurate perceptions have probably been fuelled by misrepresentative news coverage of e-cigarette harms, such as that of the US outbreak of vaping-associated lung injury in 2019, which was caused by inhaling vitamin E acetate, an additive in cannabis vaping devices, rather than standard nicotine e-cigarettes.4 In an effort to uphold the precautionary principle, the health community may have inadvertently aided the promotion of misinformation.5"

===2022: [https://pubmed.ncbi.nlm.nih.gov/36225984/ Public Health Practitioners' Knowledge towards Nicotine and Other Cigarette Components on Various Human Diseases in Pakistan: A Contribution to Smoking Cessation Policies]===

===2022: [https://www.biznews.com/health/2022/08/19/burning-tobacco-nicotine-vaping Burning tobacco kills – not nicotine; Vegter clears the air]===

===2022: [https://pubmed.ncbi.nlm.nih.gov/35935711/ Effects of brief exposure to misinformation about e-cigarette harms on Twitter on knowledge and perceptions of e-cigarettes]===

===2022: [https://www.acsh.org/news/2022/02/24/lousy-vaping-studies-master-list-junk-science-16142 Lousy Vaping Studies: A Master List Of Junk Science]===

===2022: [https://www.24shareupdates.com/2022/07/01/international-health-experts-denounce-misinformation-on-nicotine/ International health experts denounce misinformation on nicotine]===

===2020: [https://ajph.aphapublications.org/doi/10.2105/AJPH.2020.305688 The Harm-Reduction Quandary of Reducing Adult Smoking While Dissuading Youth Initiation]===

===2019: [https://www.mdpi.com/1660-4601/16/4/530 Truth Telling about Tobacco and Nicotine]===

===2019: [https://www.vox.com/2019/11/22/20977418/vaping-lung-disease-ban-public-health Vaping is still safer than smoking. That message is getting dangerously muddled.]===

===2019: [https://academic.oup.com/ntr/article-abstract/22/6/1051/5426975?redirectedFrom=fulltext&login=false Younger Individuals and Their Human Right to Harm Reduction Information Should Be Considered in Determining Ethically Appropriate Public Health Actions]===

===2019: [https://academic.oup.com/ntr/article/22/7/1148/5677516 Evaluation of the Impact of a Regional Educational Advertising Campaign on Harm Perceptions of E-Cigarettes, Prevalence of E-Cigarette Use, and Quit Attempts Among Smokers]===

===2016: [https://clivebates.com/bad-science-accountability-and-courage-speech-by-ag-tom-miller/ Bad science, accountability and courage – speech by AG Tom Miller]===

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