Based on a new study published in the Harm Reduction Journal, the campaign of deception being waged by the CDC, FDA, California Department of Public Health, and other groups which oppose e-cigarettes is working. Only 11% of U.S. adults believe that electronic cigarettes are much safer than real ones. Nearly half of all adults (49%) believe that e-cigarettes are as hazardous (46%) or more hazardous (3%) than real cigarettes.
(See: Kiviniemi MT, Kozlowski LT. Deficiencies in public understanding about tobacco harm reduction: results from a United States national survey. Harm Reduction Journal 2015, 12:21.)
The study concludes that: "Clearly, the public does not show an expert understanding of tobacco/nicotine harm
reduction. These limitations in the public’s understanding have the potential to lead
to both individual and public health harms."
Importantly, the study notes that the proposed FDA deeming regulations represent a significant barrier to the accurate communication of health risks to the public: "There are some barriers to accurate and effective messaging on this topic. Currently
the FDA regulations present significant barriers for manufacturers to make cross-product
risk comparisons. The value of these barriers need to be weighed against the possible ill effects
of beliefs that are currently held by the public and that can influence behavior.
Note the FDA regulations have concerns about promoting reduced-risk products that
might increase the population level of use of this safer product. Consumers themselves,
however, can be interested in their own levels of toxicological risk—no matter the
effects on population health. When some products, like e-cigarettes and snus, are
so much less dangerous than cigarettes, it becomes unlikely that increased levels
of use could ever produce a net population health loss in comparison to cigarettes."
Ultimately, the authors conclude that: "Given the potential benefits of tobacco risk reduction strategies, public health education
efforts to increase understanding of basic harm reduction principles are needed to
address these misperceptions."
The Rest of the Story
I agree that the proposed FDA regulations represent a significant barrier to the accurate communication of risk to the public. Making e-cigarettes subject to section 911 of the Tobacco Act (the modified risk provisions) would be a public health disaster. It would prevent companies from telling consumers the truth about their products. In fact, it would force companies to hide from the public the two most important facts about e-cigarettes: (1) that they are much safer than regular cigarettes; and (2) that they do not contain tobacco.
I would add that another significant barrier to an accurate public understanding of the risk of smoking compared to vaping is that so many anti-smoking groups and health agencies, including prominent ones like the FDA and CDC, are waging a campaign of deception that has contributed significantly to the public's misunderstanding of the relative risks of using these products. It is not just that these groups need to heed the authors' advice and start communicating the truth to consumers. First, they must stop lying to consumers by telling them that e-cigarettes are more hazardous than, or equally hazardous as tobacco cigarettes.