BUFFALO, N.Y. – Most people know smoking is risky. Butthat’s not news smokers can use.
What they can benefit from is knowing the varying levels of riskassociated with different tobacco products, according to publichealth researchers at the University at Buffalo, who found that alarge number of people aren’t aware of the differences.
“Even for e-cigarettes, half of the public incorrectlybelieved them to be just as dangerous as cigarettes and anoverwhelming majority of respondents incorrectly believed smokelesstobacco to be just as dangerous as traditional cigarettes,”Marc Kiviniemi, associate professor in the Department of CommunityHealth and Health Behavior in UB’s School of Public Healthand Health Professions, and co-author Lynn Kozlowski, a professorof community health and health behavior at UB, write in the paper,published in the July issue of the journal HarmReduction.
Kiviniemi and Kozlowski also report that 75 percent of U.S.adults misperceive smokeless tobacco products as being as harmfulas cigarettes, calling it “both a considerable lack ofknowledge and a serious public health problem.” Smokelessvarieties of tobacco include chewing tobacco, snus and snuff.
Of course, that doesn’t mean these products aresafe—just safer when compared to cigarettes.“Nobody is saying there’s no risk associated withsmokeless tobacco use or e-cigarettes,” says Kozlowski.
“But the best evidence we have is that they are not asrisky as traditional cigarettes. When people are making decisions,that difference in risk is important. There seems to be thisperception that all tobacco is equally bad and that doesn’tfit the expert understanding of reality,” adds Kiviniemi.
Think of it this way: For people who continue to smoke, thereare better alternatives to cigarettes that, while still hazardous,aren’t as lethal. For nonsmokers considering taking uptobacco, there are better options than reaching for a pack ofcigarettes. “A mistaken belief can change your behavior inways that will shorten your life,” says Kozlowski, anationally recognized expert on tobacco and e-cigarettes.“The public has the right to know about the differentialrisks of these products.”
It’s also important to note, Kozlowski says, thatcigarettes and smokeless tobacco are protected by the U.S. Food andDrug Administration, meaning they can’t be banned. TheFDA’s warning labels on smokeless tobacco productsdon’t help consumers understand that they are in fact saferwhen compared to cigarettes.
“There’s an analogy here. If you think about thedifference between crossing the street in the middle of the blockat rush hour versus crossing at a crosswalk with the stop signs,you could say these are both not safe because in some sensethere’s a chance that you can get hit by a car. Butthere’s very real differences in the amount of risk,"Kiviniemi says.
"So saying this is not a safe alternative is essentially sayingthere is some risk associated with smokeless tobacco use, which istrue in a very limited sense," he adds. "I think the more importantmessage is, cigarette smoking is much more risky than smokelesstobacco. Smokeless still has some risk but not as much, and thecurrent warning labels don’t capture that very importantnuance.”
Kiviniemi and Kozlowski’s paper also found that a“concerning number” of adults think that somecigarettes, such as light and mild varieties, are safer thanso-called full flavor. While the FDA banned such descriptors, thecolor coding on the packages remains.
“Taste differences exist between these products andthere’s good reason to believe that if you’re smokingsomething that feels milder, or is easier on your chest, it’seasier to think you’re better off using that one overanother,” Kozlowski says.
The researchers analyzed data from the Health InformationNational Trends Survey (HINTS) 4 Cycle 2, apopulation-representative survey of U.S. adults conducted betweenOctober 2012 and January 2013.
Among the paper’s findings:
- 35 percent of U.S. adults did not know that various cigarettesare equal in risk.
- Current smokers were twice as likely as former smokers tobelieve that some cigarettes are safer than others.
- 13 percent of U.S. adults believe that some types of cigarettesare less harmful than others. Perceptions varied among smokers,former smokers and people who’ve never smoked. For example,current smokers were more likely than former smokers to perceivesome cigarettes as being less risky.
- 90 percent of U.S. adults aren’t aware that smokelesstobacco products are less hazardous than cigarettes.
- 51 percent think e-cigarettes are less harmful than regularcigarettes.
“It’s easy to say ‘This is safe, thisisn’t safe,’ but reality is more nuanced,” saysKiviniemi. “If you really are considering switching fromtraditional cigarettes to another product, or if you’re anonsmoker and you’re thinking about starting it because youthink they’re safe, then you really owe it to yourself to diga little deeper and get the more nuanced knowledge.”
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