Changing Perceptions of Harm of E-Cigarette vs Cigarette Use Among Adults in 2 US National Surveys From 2012 to 2017

Bottom Line: 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. The need for accurate communication of the risk of e-cigarettes to the public is urgent and should clearly differentiate the absolute from the relative harm of e-cigarettes.

The proportion of adults who perceived e-cigarettes as less harmful than cigarettes decreased from 39.4% in 2012 to 33.9% in 2017 in one survey and decreased from 50.7%  in 2012 to 34.5% in 2017 in the other. During the same period, the proportion of adults who perceived e-cigarettes to be as harmful as cigarettes increased from 11.5% in 2012 to 36.4% in 2017 in one and from 46.4% in 2012 to 55.6% in 2017 in the other. Those who perceived e-cigarettes to be more harmful than cigarettes increased from 1.3% in 2012 to 4.3% in 2017 in one and from 2.8% in 2012 to 9.9% in 2017 in the other.

Although the long-term health effects of e-cigarettes are still unknown, growing evidence and consensus among scientists and researchers suggest that the short-term health risks of completely switching to e-cigarettes are substantially less than those of continued smoking for adults who are unable or unwilling to quit cigarette smoking.

These findings underscore the urgency to convey accurate risk information about e-cigarettes to the public, especially to adult smokers who are unable or unwilling to quit smoking, and therefore could benefit most by switching from cigarettes to e-cigarettes. Public health messages may be beneficial by appropriately balancing the emphasis on the potential reduction in harm in completely switching to e-cigarette use compared with continued smoking and an accurate interpretation of the absolute harm of e-cigarette use.

Read the full report here.