Tobacco Product Harm Perceptions and New Use

Introduction:
In this article, researchers from various institutions examine the relationship between harm perceptions and new use of tobacco products among US youth. The study uses data from the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal cohort survey of adult and youth residents in the US. The study focuses on youth who completed waves 1 and 2 of the survey and did not reach 18 years old by wave 2. The researchers aim to describe tobacco product harm perception patterns among youth who had not used the products at wave 1 and to assess whether tobacco product harm perceptions at wave 1 are associated with the new use of these products between wave 1 and wave 2.

Key Points:

* The study found that low levels of absolute and relative harm perceptions for electronic cigarettes, hookah, and smokeless tobacco are positively associated with the new use of these products within the next year by US youth.
* Measures of relative perceived harm are used to provide an anchor for a comparison of the harms of novel or less prevalent tobacco products given the high awareness of the harms of smoking cigarettes.
* Absolute perceived harm is informative but has not often been explored for noncigarette tobacco products because relative perceived harm has become the standard for harm perception research.
* The lay public is often misinformed when it comes to the relative harm of tobacco products, especially the harms of novel products.
* Measuring both absolute and relative tobacco product harm perceptions might provide a more effective way of assessing the acceptability of and susceptibility to using new tobacco products.
* The study used nationally representative longitudinal data from wave 1 and wave 2 of the PATH Study to describe tobacco product harm perception patterns among youth who had not used the products at wave 1 and to assess whether tobacco product harm perceptions at wave 1 are associated with the new use of these products between wave 1 and wave 2.
* The study found that youth who believed that noncombustible tobacco products posed “no or little harm” at wave 1 were more likely to have tried those products at wave 2.
* Youth who viewed e-cigarettes, hookah, and smokeless tobacco as “less harmful” than cigarettes at wave 1 were more likely to try those tobacco products at wave 2.

Main Message:
The study highlights the importance of targeting product-specific harm perceptions to prevent new tobacco use among youth. As the prevalence of US youth cigarette use has been declining, the use of multiple tobacco products and electronic cigarette (e-cigarette) use increased through 2015, with some recent decreases seen in 2016 and 2017. Previous research has revealed an inverse relationship between harm perceptions and cigarette experimentation, with lower harm perceptions of specific tobacco products being associated with a higher prevalence of use of those products. Therefore, it is crucial to target product-specific harm perceptions, especially for noncigarette tobacco products such as e-cigarettes, hookah, and smokeless tobacco, to prevent new tobacco use among youth.

Parker, Maria A., Andrea C. Villanti, Amanda J. Quisenberry, Cassandra A. Stanton, Nathan J. Doogan, Ryan Redner, Diann E. Gaalema, et al. “Tobacco Product Harm Perceptions and New Use.” Pediatrics 142, no. 6 (December 1, 2018): e20181505. https://doi.org/10.1542/peds.2018-1505.