Assessing Adolescents' perceptions of health risks, social risks and benefits across tobacco products

Background: Numerous studies have examined adolescents’ mis(perceptions) of risks and benefits associated with cigarettes.  However, few studies have examined adolescents’ perceptions of cigarettes compared to other tobacco products, and fewer have queried about specific perceptions such as social risks, health risks and benefits. The goal of this study was to examine and compare adolescents’ perceptions of  risks and benefits across tobacco products, including conventional cigarettes, e-cigarettes, smokeless tobacco and cigars/cigarillos.

Methods: To date, 382 9^th and 12^thgraders (244 females, 138 males; X age = 15.87, SD = 1.60) have completed a survey distributed on-line via Qualtrics. After reading a scenario describing use of each tobacco product, participants reported their perceptions of product-specific risks and benefits using any number from 0-100%. Specifically, participants rated social risks (e.g., having friends upset, feeling stressed, getting in trouble), health risks (e.g., bad cough, trouble catching breath, mouth sores) and benefits (e.g., looking cool, mature, fitting in) of using cigarettes, e-cigarettes, cigars/cigarillos, and smokeless tobacco (ST).

Results: Within-subjects ANOVAs and subsequent posthoc tests indicated that adolescents believed e-cigarettes were significantly less likely to result in social risks, compared to the other  products (p < 0.01). E-cigarettes were also believed to be less likely to result in health risks, followed by ST (p < 0.01). Conversely, e-cigarettes were rated as the product most likely to help someone fit in (p < 0.01) and were rated just as likely as cigarettes and cigars to make them look cool.

Conclusions: Results show that while adolescents perceive the benefits from using e-cigarettes and cigarettes (fitting in or looking cool) as the same or slightly higher, they perceive e-cigarettes as being overall less harmful. These findings suggest that adolescents may initiate use with e-cigarettes because they perceive e-cigarettes confer the supposed benefits of traditional tobacco products without the health risks.