Why is it so difficult to talk about the risks of e-cigarettes?

A growing proportion of American adults consider the vapes as or even more dangerous than cigarettes, according to a study done today. The results show how difficult it is to accurately describe the risks badociated with e-cigarettes, particularly when public health researchers still identify some of these risks.

Part of the problem lies in the fact that the calculation of the benefit / risk ratio for e-cigarettes depends on who uses them. For adult smokers, completely Switching to electronic cigarettes may actually be less dangerous than smoking combustible cigarettes. But that does not mean that they are completely safe: the vapes have not been around for long enough to let us know what their long-term drawbacks might be, and for the moment there is little regulatory oversight of their ingredients or their batteries – which rarely explodes. As for non-smoker adults and minors under the age of 18, they certainly should not let go because of the potential risks of heart and lung problems, as well as nicotine addiction that may eventually lead to smoking.

It's a complex public health message to badimilate – and today's study, published in the journal JAMA Network open now, suggests that a party is getting lost in translation. It's understandable that the public does not know what to think because science is still evolving, and the scientific community also disagrees, according to Gideon St. Helen, a researcher in the field of tobacco at the University of California at San Francisco . did not participate in the study. "It's not as if the tobacco control community was united in their opinion on e-cigarettes," he says. "Some people believe that e-cigarettes are bad, and some people think they like the second coming of Christ."

Jidong Huang, Associate Professor of Management and Health Policy at Georgia State University, wanted to know what it meant for the public's perception of the vows. "We do not know what Americans are now thinking about e-cigarettes," he says. "Do they believe that e-cigarettes are safe or do they think e-cigarettes are more harmful?" So for this study, he and a team of researchers badyzed the results of two different surveys: one was an online survey conducted by Georgia State University, and the other was conducted by the National Cancer Institute. Starting in 2012, both surveys asked thousands of adults what, in their opinion, was the risk that e-cigarettes would be compared to regular cigarettes.

The team found that in 2017, more adults had developed feelings about the e-cigarette, as fewer people answered "I do not know" in the Georgia State survey. And in both surveys, the proportion of people who thought that e-cigarettes were less Cigarettes that were less harmful than regular cigarettes dropped between 2012 and 2017, the largest decline between 2012 and 2015. At the same time, the percentage of people who thought that e-cigarettes were as bad as cigarettes had risen. And although few adults thought that e-cigarettes were more than cigarettes in 2017 – 4.3% in one study and 9.9% in the other – it's still a big increase over the 1.3% and 2.8% that thought so in 2012.

According to Huang, these results mean that people have an imperfect understanding of the risks badociated with e-cigarettes, especially compared to cigarettes (which, according to the CDC, "are extremely dangerous, killing half of the term smokers.") "This what we were trying to say is that it is very difficult to communicate with the audience accurately, "he says.

It is understandable that the public does not know what to think. Robert Jackler, a professor of otolaryngology at Stanford, believes that this is partly due to the fact that the public is becoming better informed but uneven about the electronic cigarette through the media. The dangerous risks of cigarettes are old news. But the health risks of electronic cigarettes are worth publishing. We report them when scientists discover chemicals that can cause lung irritation or heart problems, or that vapes explode or poison children.

"Most of us would like adult smokers to give up their fuels and steam," he says. "Everything you see as an online news reader is a report after another revealing the worthy fact that vaping is not perfectly safe. And people misunderstand the concept of security versus safer. He compares cigarettes at a speed of 90 km / h on the highway, and electronic cigarettes to a more reasonable – but nevertheless fast – number of 75 km / h. "Both increase your risk of death, but a speed at 75 ° C is far from being as dangerous as a death injury or injury than that at 90".

Misleading the message could be risky for public health, says Huang. On the one hand, exaggerating the risks of electronic cigarettes is demonizing what could be a potentially safer (though still risky) alternative to cigarettes; on the other hand, under-selling the risks could increase the number of teenage vapotages, he says. This means that it is essential to adapt messaging to specific groups, in specific channels, Huang explains. For example, social media campaigns, which can reach a young audience, should not focus on the fact that e-cigarettes may be less risky than conventional cigarettes. But this message might be appropriate for an announcement of a whole page, for example, AARP magazine more likely to reach adult smokers.

The authors of the study point out an important limitation with their own study: data stop at 2017, which is prior to the mbadive outbreak of e-cigarette use among teens that has pushed the Surgeon General to qualify the teenager as "vaping" of the epidemic. Altria tobacco company has paid $ 12.8 billion for the purchase of a piece of the giant electronic cigarette, Juul. It is therefore possible that the perception of risk has changed since then. Another problem is that one of the surveys wondered what should be called "vapes" – switching from electronic cigarettes to electronic products steamed very early in the last years of the survey. This could make it difficult to compare from one year to the next. And Michael Ong, a professor of medicine and public health at UCLA, says investigations have failed to better understand people's perceptions. Types risks – such as heart problems, cancer or explosive devices.

Yet the results of the two surveys are mutually supportive. And for public health experts like St. Helen, the results mean that we need to improve risk communication – although it's hard to find the right balance. "I do not think it's okay to frighten people into believing that something risky is potentially less risky than you say. Because it forces people to question the scientific community, "he says. "The public can see through that anyway."