Misperceptions about the dangers associated with inhaling cigarette smoke into the lungs are common among adults and teens in the United States, according to findings from three nationally representative surveys.
Many survey respondents were not aware that inhaled chemicals in the the smoke from burning cigarettes are the main source of smoking's harm and they commonly believed that most of the harmful chemicals in cigarette smoke come from additives routinely found in cigarettes.
The findings have important implications for public health smoking cessation efforts in light of the introduction of cigarettes without additives labeled "natural" or "additive-free," which are widely, but wrongly, perceived to be safer alternatives to traditional cigarettes, said Noel Brewer, PhD, of the University of North Carolina Gillings School of Global Public Health, Chapel Hill.
The study was published in the BMJ journal Tobacco Control.
Also, in the same issue of the journal, researchers from the tobacco control group Truth Initiative led by Jennifer Pearson, PhD, reported that smokers of the Natural American Spirit cigarette brand were 22 times more likely than smokers of other brands to inaccurately perceive their cigarette choice as being less harmful.
The analysis of data from the Population Assessment of Tobacco and Health study revealed that 64% of Natural American Spirit smokers believed their brand to be less harmful than other cigarette brands, compared to 8.3% of smokers of other brands.
In August of 2015 the FDA issued a warning letter to Natural American Spirit producer Santa Fe Natural Tobacco Company and the manufacturers of two other cigarette brands contending that their use of the terms "natural" and "additive-free" on the cigarette packaging constitutes a claim of reduced harm.
"Additive-free has been promoted heavily by these manufacturers, and it's no accident that smokers perceive these brands to be less harmful," Brewer told MedPage Today. "It's sort of like the 'low-tar' lie. Smokers of low-tar cigarettes believed these products were safer, but they weren't."
Brewer noted that the 2009 Tobacco Control Act requires cigarette manufacturers to identify all chemical additives in their brands, but it is not yet clear how to best communicate this information to the public.
"We did this study to better understand what people knew about the chemicals in the cigarettes and whether certain chemicals might discourage people from smoking."
Brewer and colleagues conducted telephone surveys with 1,125 adolescents and 5,014 adults plus an internet survey with a convenience sample of 4,137 adults.
The surveys were conducted to assess respondents understanding of cigarette smoke constituents in general, and 24 specific constituents.
Among the main findings:
· Between 43% and 72% of participants incorrectly believed that harmful chemicals in cigarette smoke mostly come from additives introduced by cigarette manufacturers (43% adolescents, 61% of adults surveyed by phone, and 72% of adults surveyed via internet)
· Almost all participants had heard that nicotine is in cigarette smoke (89%-95%), and many had also heard about carbon monoxide (59%-70%), ammonia (39%-53%), arsenic (42%-66%), and formaldehyde (41%-68%)
· Fewer than one-quarter had heard of most other listed constituents commonly found in cigarette smoke
· Constituents most likely to discourage respondents from wanting to smoke were ammonia, arsenic, formaldehyde, hydrogen cyanide, lead, and uranium
Most adults surveyed (61% and 73%) wrongly believed that most of the harmful chemicals in cigarettes come from the additives rather than from the burning cigarettes.
Asked if cigarette filters trap all harmful chemicals in cigarette smoke, 22% of adults surveyed via the internet and 33% surveyed by phone, as well as 27% of adolescents, said they believed they did. Adult smokers believed that cigarette filters remove more harmful chemicals from cigarette smoke than non-smokers (weighted means: 1.81, SE 0.02 versus 1.90, SE 0.04; P=0.04).
"The widespread misunderstanding that constituents come from tobacco additives highlights the importance of banning the use of 'additive-free' and similar terms that falsely suggest healthfulness and risk reduction; however, educational campaigns may more effectively improve understanding of constituents that dispel myths about additives," the researchers wrote.
Brewer said while there is still disagreement about whether additives like ammonia, arsenic, and formaldehyde make cigarettes more dangerous, the focus on additives largely misses the point.
"Additives don't change tobacco and make it dangerous. Tobacco is inherently dangerous when you burn it and smoke it," he said. "If you burned and inhaled pretty much anything that would be dangerous. Cigarettes are an inherently flawed product that is designed to kill people."
[Thomas: Have you been thinking that some cigarettes are "safe?"
The truth is ALL cigarettes are Sickerettes!}