A study in JAMA reveals the percentage of U.S. adults “who perceived e-cigarettes to be as harmful as or more harmful than [combustible] cigarettes increased substantially from 2012 to 2017.”

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The authors analyzed data from the Tobacco Product and Risk Perception Survey (TPRPS), which was conducted by the Tobacco Center of Regulatory Science at the School of Public Health at Georgia State University at Atlanta. They also used data from the Health Informational National Trends Survey by the National Cancer Institute in Rockville, Maryland (HINTS).

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The study’s authors found from 2012 to 2017, the “proportion of adults who perceived e-cigarettes as less harmful” than combustible cigarettes decreased from 39.4 to 33.9 percent in the TPRPS and from 50.7 to 34.5 percent in the HINTS. In the same period, the number of adults who say e-cigarettes are as harmful as cigarettes jumped from 11.5 percent to 36.4 percent in the TPRPS survey and from 46.4 to 55.6 percent in the HINTS survey

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These findings “underscore the urgency to convey accurate risk information about e-cigarettes to the public, especially adult smokers who are unable or unwilling to quit smoking,” the authors note. They also added that misperceptions about the relative harm of electronic cigarettes and vaping devices may “deter current smokers from initiating or continuing of e-cigarettes.”

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This research is consistent with a 2018 study that found “a majority of adults erroneously link nicotine to cancer.” Researchers at PinneyAssociates, a pharmaceutical research firm, analyzed data from the 2017 HINTS and found 53 percent of respondents “said they believe that nicotine causes most of the cancer related to smoking.”

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Unfortunately, actions by state lawmakers have fueled misperceptions on the efficacy of e-cigarettes and vaping devices. In 2019, several states introduced bills to regulate, tax, and even prohibit electronic cigarettes. States have brought forth Tobacco 21 and Vaping 21 proposals, which would severely restrict access to cigarettes and THR devices. Other legislation would regulate e-cigarettes as tobacco products.

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Across the country, lawmakers have also introduced draconian taxes on vaping devices, despite the negative impact of similar taxes in recent years. In 2016, Pennsylvania enacted a 60 percent wholesale floor tax on e-cigarettes. Within a year, an estimated 120 vape shops closed in the commonwealth.

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There is also legislation in California, Hawaii, and New York banning flavors other than tobacco and menthol in tobacco products and vaping devices. These bans were created even after a study of nearly 70,000 vapers found flavors played an important role in e-cigarette initiation and continued use.

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Approximately three million Americans have used e-cigarettes and vaping devices to quit smoking, and a 2019 study found the use of these products to be “twice as effective as nicotine replacement [therapy] in helping smokers quit.” Notable public health groups, including Public Health England, the Royal College of Physicians, American Cancer Society, and National Academies of Sciences, Engineering, and Medicine have found e-cigarettes are less harmful than combustible cigarettes.

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Rather than imposing arbitrary taxes, onerous regulations, and legislation banning flavors, lawmakers should promote the use of e-cigarettes and vaping devices as effective tobacco cessation tools that have helped millions of American adults quit smoking.

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Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute or Tobacco Harm Reduction 101.