Department of Psychology, Addiction and Mental Health Group (AIM), University of Bath, Bath, UK.
MRC Integrative Epidemiology Unit (IEU), School of Psychological Science, University of Bristol, Bristol, BS81TU, UK.
Nicotine Tob Res. 2022 Nov 12;24(12):1945-1950. doi: 10.1093/ntr/ntac163.
E-cigarettes are increasingly being viewed, incorrectly, as more harmful than cigarettes. This may discourage smokers from switching to e-cigarettes. One potential explanation for these increasingly harmful attitudes is conflicting information presented in the media and online, and from public health bodies.
In this prospectively registered online study, we aimed to examine the impact of conflicting public health information on smokers' and vapers' e-cigarette harm perceptions. Daily UK smokers who do not vape (n = 334) and daily UK vapers (n = 368) were randomized to receive either: (1) a consistent harm reduction statement from two different public health bodies (Harm Reduction), (2) a consistent negative statement about e-cigarette harms from two different public health bodies (Negative), (3) a harm reduction statement from one public health body and a negative statement from another (Conflict), and (4) a statement of the risks of smoking followed by a harm reduction statement from one public health body and a negative statement from another (Smoking Risk + Conflict). Participants then answered questions regarding their perceptions of e-cigarette harm.
The Negative condition had the highest e-cigarette harm perceptions, significantly higher than the Smoking Risk + Conflict condition (MD = 5.4, SE = 1.8, p < .016, d = 0.3 [CI 0.73 to 10.04]), which did not differ from the Conflict condition (MD = 1.5, SE = 1.8, p = .836, d = 0.1 [CI -3.14 to 6.17]). The Conflict condition differed from the Harm Reduction condition, where harm perceptions were lowest (MD = 5.4, SE = 1.8, p = .016, d = 0.3 [CI 0.74 to 10.07]).
These findings are the first to demonstrate that, compared to harm reduction information, conflicting information increases e-cigarette harm perceptions amongst vapers, and smokers who do not vape.
This research provides the first empirical evidence that conflicting information increases smokers' and vapers' e-cigarette harm perceptions, compared to harm reduction information. This may have a meaningful impact on public health as e-cigarette harm perceptions can influence subsequent smoking and vaping behavior. Conflicting information may dissuade smokers, who have the most to gain from accurate e-cigarette harm perceptions, from switching to e-cigarettes. These findings indicate that public health communications that are consensus-based can lower harm perceptions of e-cigarettes, and have the potential to reduce morbidity and mortality attributable to tobacco smoking.
电子烟正被错误地视为比香烟更有害，尽管这种看法并不正确。这可能会阻止吸烟者改用电子烟。这些日益恶化的态度的一个潜在解释是，媒体和网络上以及公共卫生机构提供的信息相互矛盾。
在这项前瞻性注册的在线研究中，我们旨在研究相互矛盾的公共卫生信息对吸烟者和电子烟使用者对电子烟危害认知的影响。每天不吸电子烟的英国吸烟者（n=334）和每天吸电子烟的英国电子烟使用者（n=368）被随机分配到以下四种情况之一：（1）两个不同的公共卫生机构发布的一致的减少危害声明（减少危害）；（2）两个不同的公共卫生机构发布的关于电子烟危害的一致负面声明（负面）；（3）一个公共卫生机构发布的减少危害声明和另一个公共卫生机构发布的负面声明（冲突）；（4）吸烟风险声明后，一个公共卫生机构发布的减少危害声明和另一个公共卫生机构发布的负面声明（吸烟风险+冲突）。参与者随后回答了有关电子烟危害认知的问题。
负面条件下的电子烟危害认知最高，明显高于吸烟风险+冲突条件（MD=5.4，SE=1.8，p<.016，d=0.3[CI 0.73 至 10.04]），后者与冲突条件（MD=1.5，SE=1.8，p=0.836，d=0.1[CI-3.14 至 6.17]）无差异。冲突条件与危害降低条件不同，后者的电子烟危害认知最低（MD=5.4，SE=1.8，p=0.016，d=0.3[CI 0.74 至 10.07]）。
这些发现首次表明，与减少危害信息相比，冲突信息会增加电子烟使用者和不吸电子烟的吸烟者对电子烟危害的认知。
这项研究首次提供了经验证据，表明与减少危害信息相比，相互矛盾的信息会增加吸烟者和电子烟使用者对电子烟危害的认知。这可能会对公共健康产生有意义的影响，因为电子烟危害认知会影响随后的吸烟和电子烟使用行为。相互矛盾的信息可能会阻止最需要准确电子烟危害认知的吸烟者改用电子烟。这些发现表明，基于共识的公共卫生信息可以降低电子烟的危害认知，并有可能降低与吸烟有关的发病率和死亡率。
