Opportunities and Considerations for Addressing Misperceptions About Relative Risks of Tobacco Products among Adult Smokers

Aug.16.2023
Opportunities and Considerations for Addressing Misperceptions About Relative Risks of Tobacco Products among Adult Smokers
FDA’s Center for Tobacco Products Director, Brian King, commented on addressing misperceptions about the risks of tobacco products among adult smokers.

On August 15th, Brian King, Director of the Center for Tobacco Products (CTP) at the Food and Drug Administration (FDA), published an article in the prestigious scientific journal "WILEY" titled "Commentary on Wackowski et al.: Opportunities and Considerations for Addressing Misperceptions About the Relative Risks of Tobacco Products among Adult Smokers." This article discusses the chances and factors to be considered in tackling the misperceptions amongst adult smokers regarding the comparative risks of tobacco products.


In the article, Brian King mentions that Wackowski and colleagues conducted a survey on American adult cigarette smokers and found that only about 20% of them believe that e-cigarettes contain fewer harmful chemicals than traditional cigarettes. Among these individuals, half of them perceive e-cigarettes as less harmful. The awareness of reduced chemical content is positively associated with the use and interest in e-cigarettes.


Brian King suggests that incorrect perceptions about the relative risks of tobacco products, particularly e-cigarettes, among adult cigarette users can be corrected through education.


Meanwhile, Brian King mentioned in the article three factors that need to be considered when developing and implementing strategies for educating adult smokers about the relative risks of tobacco products.


The following is a translation of the original text: "The government announced today that it will be implementing a new policy to address the rising crime rates in the city. The policy includes increased funding for law enforcement agencies, the establishment of neighborhood watch programs, and stricter penalties for offenders. The government hopes that these measures will improve public safety and reduce crime rates. However, some critics argue that a more holistic approach is needed, including addressing the root causes of crime such as poverty and lack of social support. Only time will tell if the new policy will be successful in combating crime in the city.


Regulation of tobacco and nicotine products varies across different countries worldwide. In the United States, the Food and Drug Administration (FDA) is empowered to oversee the manufacturing, marketing, and distribution of tobacco products, including cigarettes and e-cigarettes, in order to safeguard public health.


There are no tobacco products that can be considered safe [1]. However, within the continuum of risk associated with tobacco products, smoking products such as cigarettes pose the greatest risks [1]. Substantial progress has been made in reducing tobacco consumption through evidence-based comprehensive population-level strategies. Despite these advancements, the global death toll from tobacco smoking still exceeds 8 million people annually.


Given that the majority of adult cigarette smokers initiate tobacco use during adolescence, prevention strategies, including price increases, smoke-free policies, and mass media campaigns, are crucial in reducing tobacco-related diseases and deaths. Furthermore, providing accessible, evidence-based cessation strategies for populations, healthcare systems, and individuals among tobacco product users remains essential. With the continually evolving landscape of tobacco products, shifting towards lower-risk alternatives, such as e-cigarettes, is thought to reduce the risks associated with smoking. The 2018 report from the National Academies of Sciences, Engineering, and Medicine in the United States concluded that there is "conclusive evidence that completely substituting e-cigarettes for combustible tobacco cigarettes reduces users' exposure to numerous toxicants and carcinogens found in combustible tobacco cigarettes.


Recently, a representative survey conducted by Wackowski et al. focused on American adult cigarette smokers. The study found that only about 20% of participants believed that e-cigarettes contained fewer harmful chemicals compared to traditional cigarettes. Among this group, half of the individuals perceived e-cigarettes as less harmful. The findings indicated a positive correlation between awareness of reduced chemical content and the use and interest in e-cigarettes.


The research conducted by Wackowski et al. suggests that there is an opportunity to educate adult smokers about the relative risks of tobacco products, particularly e-cigarettes. However, these educational efforts must be evidence-based. When developing content, delivery methods, and target audience, a data-driven approach should be employed. It is particularly important to assess the benefits for the target population (i.e. adult smokers) as well as the potential risks for unintended populations, such as adolescents.


When formulating and implementing strategies related to the relative risks of tobacco products for adult smokers, several factors need to be taken into consideration.


First and foremost, it is unsafe for adolescents to use tobacco products in any form, including e-cigarettes. Therefore, it is crucial to implement robust strategies to prevent youth from engaging in tobacco use. However, efforts to deter young individuals from starting should not impede endeavors to promote smoking cessation and educate adult smokers about the relative risks associated with tobacco products.


Furthermore, the preferred method for adult smokers to quit smoking should be scientifically proven safe and effective products, including FDA-approved medications and devices. Behavioral counseling and medications are both effective, and combining them increases the likelihood of quitting smoking. Currently, no e-cigarette has been approved by the FDA for smoking cessation, which requires evidence of both safety and efficacy. Increasingly, studies indicate that certain e-cigarettes may facilitate smoking cessation among adults; however, due to the toxins present in e-cigarette aerosol, further high-quality studies are still needed to examine short-term and long-term clinical outcomes, including pulmonary effects.


Thirdly, the FDA has authorized 23 tobacco-flavored e-cigarette products and devices for adult smokers who choose to use e-cigarettes. However, in order to fully reap the health benefits from these products, it is crucial for adult smokers to transition completely from traditional cigarettes to e-cigarettes. Biomarker assessments indicate that dual users who simultaneously use both e-cigarettes and traditional cigarettes typically exhibit high levels of toxic substance exposure similar to those seen in exclusive smokers. A significant number of American adults engage in dual use when using e-cigarettes; in 2021, 29.4% are current smokers, 40.3% were former smokers, and 30.3% have never smoked. Simultaneously using traditional cigarettes and e-cigarettes can either serve as a pathway to complete transition or maintain addiction. To maximize the likelihood of the former, adult smokers must fully switch to e-cigarettes and avoid prolonged dual use. Since no tobacco product is safe, the ultimate goal should be to quit using all tobacco products, including e-cigarettes.


In summary, there are opportunities to educate adult smokers about the relative risks of tobacco products, including e-cigarettes, using evidence-based methods. However, these efforts should go hand in hand with efforts to prevent youth from using tobacco products, encouraging the use of FDA-approved cessation therapies, and emphasizing the importance for adult smokers to completely switch from combustible cigarettes to e-cigarettes. These efforts can be implemented by both government and non-government stakeholders. For example, the FDA has recently initiated formative research on eliminating misconceptions about nicotine and communicating potential risks for adult smokers. This is in addition to the FDA's ongoing efforts to prevent youth tobacco use through its "Real Cost" public education campaign. Furthermore, there are also opportunities to continue innovating new tobacco cessation therapies to further reduce tobacco-related diseases and deaths.


References:


Analysis on Wackowski et al.'s study: Examining Ways to Correct Misconceptions About Tobacco Product Risks Among Adult Smokers



Disclaimer

This article is provided solely for professional research, industry discussion, and informational purposes. Any references to brands, companies, products, technologies, or policies are made for factual reporting and analytical purposes only, and do not constitute endorsement, recommendation, promotion, or advertising by 2Firsts.

Nicotine-containing products, including but not limited to cigarettes, e-cigarettes, heated tobacco products, and nicotine pouches, carry significant health risks. Readers are responsible for complying with all applicable laws and regulations in their respective jurisdictions, including age restrictions and access limitations.

The information contained in this article should not be regarded as investment, legal, medical, regulatory, or commercial advice. While 2Firsts strives to ensure the accuracy and reliability of its content, it does not assume liability for any direct or indirect loss arising from errors, omissions, inaccuracies, or reliance on the information contained herein.

This article is not intended for individuals below the legal age for accessing tobacco or nicotine-related information in their jurisdiction.

 

Copyright Notice

This article is either original content produced by 2Firsts or content reproduced, translated, summarized, or adapted from third-party sources with attribution where applicable. The intellectual property rights of the original content remain with 2Firsts or the respective original rights holders.

No individual or organization may copy, reproduce, distribute, republish, modify, translate, or otherwise use this content without prior authorization. Any unauthorized use may result in legal action.

For copyright-related inquiries, corrections, or removal requests, please contact: info@2firsts.com.

 

AI-Assisted Translation and Editing Notice

Portions of this article may have been translated, edited, or reviewed with the assistance of artificial intelligence tools to improve efficiency and readability. Due to the limitations of AI-assisted translation and editing, discrepancies, omissions, or inaccuracies may exist when compared with the original source.

Where applicable, readers are advised to refer to the original source for the most complete and accurate information. If you identify any errors or believe that any content infringes upon your rights, please contact us at info@2firsts.com, and we will review and address the matter promptly.

Malaysia's Poisons Board Backs New Vape Nicotine Exemption After Unanimously Opposing 2023 Proposal
Malaysia's Poisons Board Backs New Vape Nicotine Exemption After Unanimously Opposing 2023 Proposal
Malaysia's Poisons Board has endorsed Health Minister Dzulkefly Ahmad's proposal to exempt liquid nicotine used in vaping products from the Poisons List, according to a November 2, 2026, report by CodeBlue. The Board unanimously opposed a similar proposal in 2023, but the government proceeded with the exemption. The Kuala Lumpur High Court invalidated the 2023 decision in May 2026, and the government withdrew its appeal in August. No new ministerial order has been published. The development raises questions about the interaction between Malaysia's two regulatory frameworks and the treatment of RM354.51 million in excise duties collected on e-cigarette and vape products between May 2023 and June 11, 2026.
Regulations
Nov.03
Couche-Tard Posts Double-Digit U.S. Same-Store Growth in Other Nicotine Products, Led by Pouches
Couche-Tard Posts Double-Digit U.S. Same-Store Growth in Other Nicotine Products, Led by Pouches
Alimentation Couche-Tard said U.S. same-store sales in its “other nicotine products” category grew at a double-digit rate in the first quarter of fiscal 2027, led by nicotine pouches, while overall U.S. same-store merchandise revenues increased 1.7%. The company also said its Canadian nicotine business continued to face regulatory pressure and illicit-market headwinds. The U.S. performance coincides with Couche-Tard's participation in efforts to reopen Canadian convenience-store access to authorized nicotine pouches, though the company has not established a direct causal link between the two.
Sep.14
UK-Listed Consumer Goods Group Supreme Sees Vape Duty as Potential Consolidation Opportunity, Holds FY27 Outlook
UK-Listed Consumer Goods Group Supreme Sees Vape Duty as Potential Consolidation Opportunity, Holds FY27 Outlook
UK-listed consumer goods group Supreme plc says it continues to expect FY27 trading to meet market expectations as the Vaping Products Duty takes effect on October 1, while maintaining a comparatively positive view of the new tax and compliance regime. Supreme has said the framework could increase compliance complexity for smaller operators and contribute to market consolidation, while its manufacturing, compliance and distribution scale may allow it to gain share. Its 88Vape brand will retain its value positioning.
Sep.18
U.S. Expands Illicit Vape Enforcement as ATF Brings PACT Act Powers Into Trade Fraud Task Force
U.S. Expands Illicit Vape Enforcement as ATF Brings PACT Act Powers Into Trade Fraud Task Force
The U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives said on September 23 that it has joined the interagency Trade Fraud Task Force to strengthen enforcement against illegal, misdeclared and smuggled vape and tobacco products. ATF will bring its authority under the Prevent All Cigarette Trafficking Act into the task force, including registration, reporting, shipping and record-inspection requirements covering interstate sales of electronic nicotine delivery systems. ATF said the move will strengthen its ability to trace illicit products from U.S. points of entry through domestic trafficking and distribution networks.
News
Sep.28 by 2Firsts Perspectives
Swedish-Founded Nicotine Pouch Retailer GotPouches Shifts to U.S.-Based Operations, Reaching Over 25 States
Swedish-Founded Nicotine Pouch Retailer GotPouches Shifts to U.S.-Based Operations, Reaching Over 25 States
Swedish-founded online nicotine pouch retailer GotPouches has completed the localization of its U.S. operations under UpNorth Retail LLC, with corporate operations in Franklin, Tennessee, domestic fulfillment from Nashville and U.S.-based customer support. The company says its catalog covers more than 20 nicotine pouch brands and it currently serves customers in more than 25 U.S. states.
Sep.18
Product | OXVA Introduces XLIM PRO 4 With Liquid-Level Anti-Burn Technology and Dedicated Pods
Product | OXVA Introduces XLIM PRO 4 With Liquid-Level Anti-Burn Technology and Dedicated Pods
Vaping brand OXVA introduced the XLIM PRO 4 refillable pod system in October 2026, featuring Anti-Burn Tech (ABT) based on smart e-liquid-level detection. The system can issue refill alerts and stop power output when e-liquid levels become too low. ABT requires the XLIM PRO 4 device and a dedicated XLIM ABT cartridge. Standard XLIM pods remain compatible but do not support ABT protection. OXVA previously introduced temperature-based anti-burn technology in the XLIM Pro 2 DNA, developed with Evolv. The new device features a 1,800mAh battery, 5–30W output and a 0.98-inch HD color screen. OXVA's official store lists the device at $37.90 and dedicated ABT replacement cartridges at $12.99. Independent testing confirmed the low-liquid protection response but recorded varying cartridge lifespans.
product
Oct.30