Misconceptions about nicotine could hinder smoking cessation efforts and increase premature deaths: study

Widespread misconceptions about nicotine may have profound consequences on public health, a new study has found.

With a majority of adults who smoke inaccurately believe nicotine causes cancer, potentially preventing them from switching to safer alternatives, researchers at the Altria Center for Research and Technology examined how different perceptions of nicotine influenced smoking cessation and switching to non-combustible products, like electronic nicotine delivery systems or smokeless tobacco, over multiple waves of the PATH study in the US.

The research, published in Harm Reduction Journal, utilised an agent-based model analyzing data from the nationally representative Population Assessment of Tobacco and Health (PATH) study,

The researchers focused on the question: "Do you believe nicotine is the chemical that causes most of the cancer caused by smoking cigarettes?" Responses ranged from “Definitely not” to “Definitely yes,” reflecting varying degrees of understanding of nicotine's role in smoking-related harm.

Participants who correctly responded “Definitely not,” indicating they understood that nicotine is not the main cause of cancer, had a switch rate of 8.39 per cent to non-combustible products. This resulted in a net benefit of preventing nearly 800,000 premature deaths over an 85-year period in the US.

In contrast, those who inaccurately believed nicotine causes most of the harm, responding “Definitely yes,” had a switch rate of just 2.59 per cent, leading to an estimated 300,000 additional premature deaths over the same period.

The researchers argue that improving awareness around the real risks of smoking—primarily caused by the inhalation of harmful substances from burning tobacco, not nicotine—could significantly increase switching to potentially reduced-risk products and save hundreds of thousands of lives.

“Accurate knowledge regarding the role of nicotine is associated with higher switch rates and prevention of premature deaths. Our findings suggest that promoting public education to correct nicotine misperceptions has potential to benefit public health,” the researchers wrote.