Accurate labels like 'aerosol' or 'chemicals' increase perceived risks of e-cigarette use

When it comes to the harms caused by tobacco products, how information is framed and presented has important consequences for audience risk perception, individual behavior, and public policy-making. Tobacco marketers use a variety of framing devices to downplay the risks of cigarettes, e-cigarettes, and exposure to secondhand smoke.

Tobacco-free laws continue to play an important role in protecting everyone from harmful tobacco emissions and help reduce tobacco use in the general population. While overall rates of smoking continue to decline, e-cigarette use, particularly among youth and young adults has become very prevalent in recent years, including on college campuses. Tobacco-free campus policies have proven to play important roles in reducing the number of new users and in helping current users quit; however, one-sixth of smoke-free campus policies do not prohibit e-cigarette use. Despite mounting evidence on the harm posed by e-cigarettes (also known as "vaping") and their emissions, they are perceived to pose a lower risk than traditional cigarettes.

Researchers sought to better understand the association between the labels used to describe the secondhand emissions from e-cigarettes and young adults' level of perceived risks. The study aimed to determine if the terminology used to describe secondhand emissions from e-cigarettes influence undergraduate students' perceptions of its harmfulness and to examine whether perceived harmfulness of exposure to e-cigarettes was associated with support for tobacco-free campus polices that include e-cigarettes.

"This study is the first known investigation of whether the word used for e-cigarette emissions is associated with perceived harmfulness of secondhand exposure. It is also the first to identify an association between perceptions of harmfulness from secondhand exposure to e-cigarettes and support for the implementation of a 100% tobacco-free campus policy," said Rossheim, assistant professor in the Department of Global and Community Health.

Findings reveal that the words used to describe tobacco products and their secondhand emissions is critical in forming young adults' perceptions of e-cigarettes and their harmfulness, and that simple wording choices can have an important impact on perceived risk. The researchers conclude that due to the severe risks associated with e-cigarettes and secondhand smoke, that communications associated with e-cigarettes and tobacco-free campuses should accurately label their emissions as "chemicals" and "aerosols." They urge that legislation be passed to regulate the marketing practices of the e-cigarette industry so they cannot downplay the harmfulness of their products.

Students who were asked questions that used "chemicals" or "aerosols" to describe e-cigarette's secondhand emissions were twice as likely to perceive the emissions to be "harmful" or "very harmful," compared to students asked about e-cigarette "vapor." Students who did not use e-cigarettes were nearly five times more likely to see e-cigarette emissions as "harmful/very harmful" compared to those who do use e-cigarettes.

"Smoke-free and tobacco-free campus environments are always a common-sense public health measure, and are especially so at this time, given the strong link between tobacco use and COVID-19 transmission among young people," says Rossheim. "Colleges and universities are encouraged to urgently adopt tobacco-free campus policies to help prevent the spread of coronavirus."

The study was completed at a large, public university in Virginia that does not currently have a smoke-free campus policy and included data gathered from 791 undergraduate students.