American Teens’ Gross Misperception of Nicotine Leaves FDA Study Authors Unperturbed

A new study by Erin Keely O’Brien and colleagues at the FDA Center for Tobacco Products (CTP) underscores the FDA’s failure to accurately educate consumers about nicotine.  The report appears in Nicotine & Tobacco Research.

The authors analyzed perceptions of nicotine among 12-17 year-old participants during two waves of the Population Assessment of Tobacco and Health (PATH) study, in 2016-17 and 2017-18.

While their journal article includes some positive messages on tobacco harm reduction, its main finding is worrisome: 75% of surveyed youth “incorrectly responded that nicotine is the main substance that causes smoking-related cancer.”  O’Brien noted that this figure was “similar to adults.”   

O’Brien et al. do acknowledge a critical fact: “…it is tobacco combustion and the accompanying release of thousands of harmful chemicals, rather than nicotine itself, that is responsible for most [sic] of the negative tobacco-related health outcomes (eg, the myriad of cancers related to tobacco use).”  They even acknowledge that the FDA’s reduced-nicotine standard for cigarettes “would not decrease the toxicity or harmfulness” of smoking.

The authors reveal why the FDA has done so little to educate consumers about nicotine: “Among youth who did not use at [the 2016-17 wave], greater harm perceptions of nicotine in cigarettes, e-cigarettes, and NRT were associated with lower likelihood of reporting current tobacco use at [the subsequent wave].” (Emphasis added)  They call these misperceptions “protective (preventing initiation among youth who do not use tobacco),” but they also label them “harmful,” in so much as these misperceptions are “preventing youth who use combustible tobacco from switching to [pharmaceutical nicotine].”

In other words, the FDA authors think that teens who mistakenly believe that nicotine kills are more likely not to initiate tobacco.  Even more ominously, “Among youth who currently used cigarettes or e-cigarettes [in the 2016-17 wave], nicotine perceptions did not predict switching to e-cigarettes or cigarettes [in the subsequent wave].”  Of course not.  The misinformation prevents teen – and adult – smokers from switching to tobacco products that are objectively no more hazardous than nicotine medicines.

O’Brien and colleagues conclude that their “findings underscore the challenge of developing effective and comprehensive communication strategies that accurately convey the effects of nicotine without encouraging tobacco use.

Why, when 480,000 Americans die from tobacco smoke inhalation every year, are FDA officials worried more about “encouraging tobacco use” than sharing accurate information about nearly harmless nicotine?  Why do they need “comprehensive communication strategies” to simply tell adult smokers the truth?  The answers lie in the government’s obsession with creating a tobacco-free society.