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Comparison of Direct and Indirect Measures of E-cigarette Risk Perceptions

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Objectives: Risk perception measures of tobacco products relative to cigarettes are used commonly and are important to tobacco research, given that they may be associated with, and predict, tobacco use. However, results may differ based on the actual measures used. This study compares direct and indirect approaches to measuring e-cigarette/cigarette risk perceptions. Methods: We compared the responses of 519 current smokers on a nationally-representative 2014 survey that gauged perceptions of e-cigarettes' harm relative to cigarettes in 2 ways: (1) a single-item direct measure of comparative harm; and (2) a 2-item indirect measure (which measured perceived levels of harm from e-cigarettes and cigarettes independently in 2 parallel questions). Results: We found that 60% of smokers rated e-cigarettes “less harmful” than cigarettes when using a direct comparative risk measure versus 73% when using an indirect measure. Agreement between measure types was fair (Cohen's kappa=0.45) and was lower for males, Blacks, older smokers, and less educated smokers. Conclusions: E-cigarettes were more likely to be rated by smokers as less harmful than cigarettes when using indirect versus direct measures. Additional methodologic research in this area is warranted given the importance of risk perceptions to tobacco control interventions, communications, policymaking, and regulation.
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Document Type: Research Article

Publication date: January 1, 2016

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  • Tobacco Regulatory Science (Electronic ISSN 2333-9748) is a rigorously peer-reviewed online scientific journal for the dissemination of research relevant to the regulation of tobacco products. The journal content includes a broad array of research domains, including chemistry, biology, behavior, community, and population-level surveillance and epidemiology, as well as knowledge syntheses (eg, meta-analyses or state-of-the-art reviews) and analytic modeling. All articles describe the policy relevance of the research outcomes. Given the global nature of tobacco regulation, particularly as a result of international and national policies, Tobacco Regulatory Science publishes high quality research that is relevant to global regulatory needs and requirements. Tobacco Regulatory Science is published electronically 6 times per year.
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