Americans Report Confusion on Whether E-Cigarette Vapor Harms Children

Although a report from the Surgeon General has determined that the aerosol vapor from e-cigarettes contains harmful chemicals like nicotine, a survey of US adults indicates that some are skeptical or unsure about the risk posed to children exposed to the vapor.

Marketing for e-cigarettes sometimes claims that the water vapor they produce is harmless, meaning the devices can be used anywhere. However, studies have demonstrated evidence to the contrary, as the aerosol vapor exposes nearby nonsmokers to nicotine, which can impair development, and other unsafe chemicals like heavy metals.

So far, little research has been conducted to assess Americans’ knowledge of these health risks to adults or children. To fill this gap in the literature and inform future public health interventions, a recent study examined survey responses to determine the perceptions of harm related to youth exposure to e-cigarette aerosol; the findings were published in Preventing Chronic Disease.

Of the 4127 adults that completed the survey, around one-fifth responded that exposure to the aerosol causes children “a lot of harm.” One-third said they were unsure, and nearly 40% responded “little harm” or “some harm.” Just 5.3% answered that it causes “no harm.”

Perceptions of harm varied significantly by demographic factors and whether the respondent smoked cigarettes or used e-cigarettes. For instance, the odds of perceiving “no harm” were greater among men than women and among whites than other ethnic/racial groups. Current and former cigarette smokers and e-cigarette users were also more likely to perceive “no harm” to children from aerosol exposure.

Respondents’ certainty about the risks of e-cigarette vapor also varied widely. Men were more likely to answer the survey question with “don’t know” than women, as were adults aged 45 to 64 compared with those aged 18 to 24. Adults living in the West had lower odds of responding with “don’t know” than those in the Northeast.

According to the study authors, the extent of these misconceptions “underscores the importance of educating the public on the health risks” to nonusers, particularly children, who are exposed to vapor from these products. They also recommended wider implementation of smoke-free laws that include e-cigarettes as a prohibited form of smoking. Furthermore, e-cigarette marketing may need to be regulated so as not to mislead consumers into thinking they are a safer alternative to cigarettes.

Using the available tools for preventing cigarette smoking, like tobacco taxes, media campaigns, and cessation assistance, “could reduce secondhand EVP [electronic vapor product] exposure among nonusers and the misperception that EVP aerosol is harmless,” the authors wrote. “In coordination with a comprehensive approach to prevent and reduce secondhand smoke exposure and tobacco use by young people, efforts are warranted to educate the public, particularly current and former cigarette smokers and EVP users, about the potential health risks of secondhand EVP aerosol exposure among children.”