Perception of the relative harm of electronic cigarettes compared to cigarettes amongst US adults from 2013 to 2016: analysis of the Population assessment of Tobacco and health (PaTh) study data.

Introduction:
This text provides an analysis of data from the Population assessment of Tobacco and health (PaTh) study, a nationally representative longitudinal study, to assess the perception of the relative harm of electronic cigarettes (e-cigarettes) compared to cigarettes amongst US adults from 2013 to 2016. The study aims to understand the trend in perceived relative harm among US adults and its impact on smoking and vaping status.

Key Points:

* The proportion of US adults who correctly perceived e-cigarettes as less harmful than cigarettes decreased from 41.1% in 2013-2014 to 25.3% in 2015-2016.
* The proportion of US adults who perceived e-cigarettes as equally or more harmful than cigarettes increased from 53.7% in 2013-2014 to 72.7% in 2015-2016.
* The proportion of US adults who held negative relative harm perceptions of e-cigarettes increased by 24.6% and 29.6% for current smokers and vapers, respectively, within three years.
* Former smokers who used e-cigarettes and believed they were equally or more harmful than cigarettes had significantly higher rates of smoking relapse.
* Current smokers were less likely than current e-cigarette users to perceive e-cigarettes as less harmful than cigarettes (29.3% vs. 43.5%).
* The study suggests that inaccurate misperceptions amongst adult smokers will continue to deteriorate unless effective intervention is implemented.
* The model estimated that 64.3% of US adult smokers would report e-cigarettes as being equal to or more harmful than cigarettes in Wave 3, a difference of 4.1% percentage points compared to the PaTh data (68.4%).

Main Message:
The study highlights a growing misperception of the relative harm of e-cigarettes among the adult smoking population in the US. This misperception may deter adult smokers from trying or continuing the use of these products, which could have a negative impact on public health. The study emphasizes the urgent need for accurate communication of the risk differentials between cigarettes and e-cigarettes, especially from public health agencies and regulators, to provide adult smokers with clear, objective, and evidence-based health information. This information is necessary for individuals to make informed decisions on which product to use to reduce or replace their cigarette consumption.

Malt L, Verron T, Cahours X, et al. Perception of the relative harm of electronic cigarettes compared to cigarettes amongst US adults from 2013 to 2016: analysis of the Population assessment of Tobacco and health (PaTh) study data. harm reduction journal. 2020;17(1):65. doi:10.1186/s12954-020-00410-2