Harm perceptions across vaping product features: An on‐line cross‐sectional survey of adults who smoke and/or vape in the United Kingdom

Abstract

AbstractBackground and aimsVaping products are diverse with a wide variety of features, and popular products change rapidly. This study examined the features and types of vaping products that people who smoke and/or vape perceive contribute to the health harms of vaping.Design, setting and participantsThis was a cross‐sectional survey co‐designed with adults who smoked/vaped and pre‐registered. An on‐line survey (November 2022) was used of a convenience sample of adults in the United Kingdom who smoked and/or vaped (n = 494).MeasurementsAs primary outcomes, respondents were asked to select any of 15 vaping product features they perceived might have any effect on the health harms of vaping (for each: selected, not selected). Independent variables were smoking/vaping status (smoke and vape; vape, formerly smoked; vape, never regularly smoked; smoke, do not currently vape); relative vaping harm perceptions [less harmful than smoking (accurate), equally/more harmful than smoking or do not know/refused (other)]. Binary logistic regressions were used to compare outcomes by current vaping/smoking status and relative harm perceptions, adjusting for age and sex.FindingsMost people (54.7%) selected between one and three features. The most frequently selected were nicotine concentration (62.2%) and amount of e‐liquid consumed (59.1%), followed by nicotine type (e.g. salt or freebase; 33.0%), source/purchase location (25.3%), flavours (24.7%), temperature to heat e‐liquid (21.1%), heat produced by device (20.9%), e‐liquid brand (20.9%), amount of emissions (18.6%), device type (e.g. disposable, pod, tank; 17.2%), material of tank (17.0%), power/wattage (13.0%), device brand (8.1%), device size (4.1%) and device weight (2.4%). Higher nicotine concentrations, more e‐liquid and salt (versus freebase) nicotine were perceived to confer greater harms. Disposables were perceived as slightly more harmful than reusable devices. There were few differences by current vaping/smoking status and between those with accurate (versus other) harm perceptions of vaping relative to smoking (P > 0.05 for most contrasts, adjusting for age and sex).ConclusionsCertain features and types of vaping products [higher nicotine concentrations, more e‐liquid consumed and salt (versus freebase) nicotine] were perceived to confer greater health harms among a sample of UK adults who smoked and/or vaped. Findings are consistent with pervasive misperceptions that nicotine is a major cause of harm, although e‐liquid volume is likely to contribute to harms.