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

===2023: [https://pubmed.ncbi.nlm.nih.gov/37137702/ Older age is associated with greater misperception of the relative health risk of e-cigarettes and cigarettes among US adults who smoke]===

*Misperceptions about the absolute risks (ie, cigarettes are not harmful) and relative risks (ie, e-cigarettes are more harmful than cigarettes) of tobacco products may contribute to sustained smoking prevalence and hesitancy to switch from cigarettes to e-cigarettes among older adults.

===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0376871623000625 Change in E-cigarette risk perception and smoking behavior of Black and Latinx individuals who smoke.] ===

*Results: The mean CPW [Cigarettes Smoked Per Week] decreased from 82.8 (SD=49.8) at baseline to 15.8 (SD=29.8) at week 6. A one-level increase in EC [E-cigarette] risk perception (i.e., EC perceived as riskier than CC [Combustible Cigarettes] from baseline to week 6) was associated with an increase in CPW (IRR: 1.83, 95% CI: 1.03; 3.24). Latinx participants were more likely to have higher CPW as EC risk perception increased compared to Black participants (IRR=1.89, 95% CI: 1.09; 3.26).

===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 ]===

*Current adult smokers appear to be poorly informed about the relative risks of e-cigarettes yet have potentially the most to gain from transitioning to these products.

*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://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767134 Association of the US Outbreak of Vaping-Associated Lung Injury With Perceived Harm of e-Cigarettes Compared With Cigarettes]===

*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]===

*Overall, we found that many people, particularly the demographic subgroups identified here, held incorrect beliefs about nicotine and potentially inaccurate beliefs about LNCs.

*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]===