European adult smokers' perceptions of the harmfulness of e-cigarettes relative to combustible cigarettes: cohort findings from the 2016 and 2018 EUREST-PLUS ITC Europe Surveys.

ABSTRACT: BACKGROUND:This study presents perceptions of the harmfulness of electronic cigarettes (e-cigarettes) relative to combustible cigarettes among smokers from six European Union (EU) countries, prior to the implementation of the EU Tobacco Products Directive (TPD), and 2?years post-TPD. METHODS:Data were drawn from the EUREST-PLUS ITC Europe Surveys, a cohort study of adult smokers (?18?years) from Germany, Greece, Hungary, Poland, Romania and Spain. Data were collected in 2016 (pre-TPD: N?=?6011) and 2018 (post-TPD: N?=?6027). Weighted generalized estimating equations were used to estimate perceptions of the harmfulness of e-cigarettes compared to combustible cigarettes (less harmful, equally harmful, more harmful or 'don't know'). RESULTS:In 2016, among respondents who were aware of e-cigarettes (72.2%), 28.6% reported that they perceived e-cigarettes to be less harmful than cigarettes (range 22.0% in Spain to 34.1% in Hungary). In 2018, 72.2% of respondents were aware of e-cigarettes, of whom 28.4% reported perceiving that e-cigarettes are less harmful. The majority of respondents perceived e-cigarettes to be equally or more harmful than cigarettes in both 2016 (58.5%) and 2018 (61.8%, P?>?0.05). Overall, there were no significant changes in the perceptions that e-cigarettes are less, equally or more harmful than cigarettes, but 'don't know' responses significantly decreased from 12.9% to 9.8% (P?=?0.036). The only significant change within countries was a decrease in 'don't know' responses in Spain (19.3-9.4%, P?=?.001). CONCLUSIONS:The majority of respondents in these six EU countries perceived e-cigarettes to be equally or more harmful than combustible cigarettes.

SUBMITTER: Gravely S 

PROVIDER: S-EPMC7526777 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature