Arshad Humairah, Jackson Sarah E, Kock Loren, Ide-Walters Charlotte, Tattan-Birch Harry
Department of Behavioural Science and Health, University College London, London, UK.
Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT 05405, US.
Drug Alcohol Depend. 2023 Apr 1;245:109806. doi: 10.1016/j.drugalcdep.2023.109806. Epub 2023 Feb 14.
Despite growing evidence that e-cigarettes are likely less harmful than cigarettes, perceptions of equal or more harm have increased worldwide. This study aimed to identify the most common reasons behind adults' perceptions of the (i) relative harm of e-cigarettes compared with cigarettes and (ii) effectiveness of e-cigarettes for smoking cessation.
Adults (N = 1646) from Northern England were recruited through online panels from December-March 2017/2018, using quota sampling to guarantee socio-demographic representativeness. Qualitative content analysis of open-ended responses was performed with codes representing reasons for a given perception about e-cigarettes. Percentages of participants who gave each reason for each perception were calculated.
823 (49.9%) participants agreed that e-cigarettes were less harmful than cigarettes, 283 (17.1%) disagreed, and 540 (32.8%) were undecided. The most common reasons for agreeing that e-cigarettes were less harmful than cigarettes were that they produce no smoke (29.8%) and fewer toxins (28.9%). Those who disagreed were most concerned about a perceived lack of trustworthy research (23.7%) and safety issues (20.8%). Lacking knowledge (50.4%) was the most common reason for being undecided. 815 (49.5%) of participants agreed that e-cigarettes were an effective smoking cessation aid, 216 (13.2%) disagreed, and 615 (37.4%) were undecided. The most common reasons participants gave for agreeing were related to e-cigarettes being successful smoking replacements (50.3%) and advice from family, friends or health professionals (20.0%). Respondents who disagreed were most concerned about e-cigarettes being addictive (34.3%) and containing nicotine (15.3%). Lacking knowledge (45.2%) was the most common reason for being undecided.
Negative perceptions of e-cigarette harm were driven by concerns about a perceived lack of research and safety issues. Adults who viewed e-cigarettes as ineffective for smoking cessation feared that they perpetuate nicotine addiction. Campaigns and guidelines that address these concerns may help promote informed perceptions.
尽管越来越多的证据表明电子烟的危害可能低于香烟，但在全球范围内，认为电子烟危害相同或更大的观念却有所增加。本研究旨在确定成年人认为（i）电子烟与香烟相比相对危害以及（ii）电子烟戒烟有效性背后最常见的原因。
2017年12月至2018年3月期间，通过在线小组从英格兰北部招募成年人（N = 1646），采用配额抽样以确保社会人口统计学代表性。对开放式回答进行定性内容分析，使用代表对电子烟特定看法原因的编码。计算给出每种看法各原因的参与者百分比。
823名（49.9%）参与者同意电子烟比香烟危害小，283名（17.1%）不同意，540名（32.8%）不确定。同意电子烟比香烟危害小的最常见原因是它们不产生烟雾（29.8%）和毒素较少（28.9%）。不同意的人最担心缺乏可靠研究（23.7%）和安全问题（20.8%）。缺乏知识（50.4%）是不确定的最常见原因。815名（49.5%）参与者同意电子烟是有效的戒烟辅助工具，216名（13.2%）不同意，615名（37.4%）不确定。参与者同意的最常见原因与电子烟成功替代吸烟（50.3%）以及家人、朋友或健康专业人员的建议（20.0%）有关。不同意的受访者最担心电子烟会上瘾（34.3%）和含有尼古丁（15.3%）。缺乏知识（45.2%）是不确定的最常见原因。
对电子烟危害的负面看法是由对缺乏研究和安全问题的担忧驱动的。将电子烟视为戒烟无效的成年人担心它们会使尼古丁成瘾持续下去。解决这些担忧的宣传活动和指南可能有助于促进明智的看法。
