Youth Underestimate the Health and Addiction Risks of Tobacco Products 

Abstract: Perception and intention studies are required by the FDA to assess new tobacco products. These studies are generally conducted as surveys of smokers, former smokers and non-smokers across the United States. A group of 21 up to 25 year olds is over sampled to more accurately estimate the impact the product might have on young never smokers. Approximately 4500 subjects are routinely included in the study. An attempt is made to match the U. S. Census to make sure that all potential users are represented. Study participants are shown labels of the new products and asked about their perceptions of the health and addiction risks using validated questionnaires. In our approach we first show participants different types of tobacco products including cigarettes, smokeless tobacco, e-cigarettes, and nicotine replacement therapy products and assess where on the health and addiction continuum the participants place the products. When compared to the never users in the general population, young participants (legal age up to 25 years of age) consistently underestimate the health and addiction risks associated with the various tobacco products. Current smokers also underestimate the risks while former smokers perceive the risks consistent with the general population. The overall general population order of perceived health risks is cigarettes > e- cigarette = smokeless tobacco > NRT. Depending on the study populations, vapor users tend to perceive e-cigarettes to have less health risks than smokeless tobacco. Smokeless tobacco users generally perceive the health risk of smokeless to be less than e-cigarettes. The new modern oral nicotine pouch products are perceived to have health risk equivalent to NRT.