Most Adults Fail To Understand That Nicotine Does Not Cause Cancer
Nicotine is present in combustible cigarettes, e-cigarettes and FDA-approved nicotine replacement therapies used to help smokers stop smoking. The FDA[1] and other authorities have concluded that there is a continuum of risk for nicotine and tobacco products, with combustible cigarettes by far the most hazardous and nicotine replacement therapies as the least hazardous. To examine adults' knowledge of tobacco and nicotine harmfulness, researchers analyzed data from 1,736 US adults in the government-run 2017 Health Information National Trends Survey (HINTS-FDA Cycle 2).
Adults' beliefs about nicotine and tobacco products are not completely wrong. For example, a majority of adults (84.7%) correctly knew that nicotine is the substance that makes people want to smoke, and 96.2% knew that cigarettes are harmful. On the other hand, other results revealed important misunderstandings that may have critical consequences for health.Among all adults, 52.9% incorrectly believed that nicotine is the substance causing most of the cancer caused by smoking, and an additional 21.2% did not know whether nicotine causes most cancer caused by smoking. Cigarette smokers were significantly more likely than e-cigarette users to incorrectly believe that nicotine causes most of the cancer caused by smoking (52.5% vs. 14.6%). In addition, while experts continue to debate the magnitude of the difference in risk between e-cigarettes and cigarettes, just 31.6% of smokers agreed that e-cigarettes are less harmful than cigarettes—including only 3.4% who are plausibly "correct" in believing they are much less harmful than combustible cigarettes.
"That adults' misperceptions about the health effects of nicotine persist despite the long-term availability of FDA-approved over-the-counter nicotine replacement products is troubling and needs to be addressed with clear communications to the public—especially smokers—that nicotine is not what is causing smoking-related disease," said Ph.D., M.P.H., the lead author on the study. "Leading public health experts[2] have called for trusted authorities to communicate clearly about nicotine to smokers, which should help them understand that there is a continuum of risk across nicotine-containing products and use that understanding to help them reduce risks to their health."About PinneyAssociates
PinneyAssociates is a pharmaceutical and consumer healthcare consulting company that helps their clients to reduce their regulatory risk and enhance the commercial and public health value of their life sciences products. PinneyAssociates consults with pharmaceutical companies that market a wide variety of prescription and over-the-counter medications. PinneyAssociates' experts have extensive expertise in abuse-deterrent drug formulation evaluation, abuse potential assessment, as well as pharmaceutical risk management, Rx-to-OTC switch, and tobacco harm reduction.All authors are employees of PinneyAssociates, Inc. PinneyAssociates provides consulting services on tobacco harm minimization (including nicotine replacement therapy and vapor products) to Niconovum USA, Inc., R.J. Reynolds Vapor Company, and RAI Services Company, all subsidiaries of Reynolds American Inc. Reynolds Americanwas purchased by British American Tobacco in July 2017. Mr. Gitchell co-holds a patent for a novel nicotine medication that has not been developed or commercialized. RAIS had no role in the conception of this research, or the analysis or interpretation of the findings.
Author Contact: To arrange an interview with the author, please contact Michelle Ertischek, at or +1 240-752-9053For more information about PinneyAssociates, please contact us at +1.301.718.8440 or , or learn more about our work at .
[1] Gottlieb and Zeller. A nicotine-focused framework for public health. 2017 Sep 21;377(12):1111-1114. Available at[2] Fairchild, Niaura and Abrams. America needs a candid smoking control champion. 13 Nov 2017. The Hill. Available from:
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