Why Do Some Adults Who are Smoking Perceive E-cigarettes to be More Harmful than Combustible Cigarettes?

Abstract Whilst e-cigarettes have been characterised by respected public health bodies as being substantially less harmful than combustible tobacco products, nevertheless research has shown that a significant minority of adults, including those who are smoking, perceive e-cigarettes to be as harmful or more harmful than combustible cigarettes. In this paper we draw upon qualitative data from interviews with U.K. adults who are smoking to look at the reasons why e-cigarettes may be viewed as more harmful than combustible cigarettes. The belief that e-cigarettes may be more harmful than combustible cigarettes was based on a complex array of knowledge, belief, reasons, fears, predictions, reactions, and judgements covering such topics as the technological i.e. non-natural nature of e-cigarettes, uncertainties as to the content of e-liquids, perceptions that these devices expose the user to greater harm resulting from their being used with greater frequency than combustible tobacco products, fear around long-term harm of e-cigarettes, scare stories in the media and concerns around addiction. There is an important need for clear communication from responsible public health bodies and the media conveying the important information to those adults who are continuing to smoke that e-cigarettes are substantially less harmful than combustible tobacco products, and that those adults who are unable or unwilling to quit smoking using validated means of smoking cessation should consider switching to e-cigarettes or other non-combustible tobacco products as a way of reducing the harms they are being exposed to as a result of continuing to smoke.