Journal of Behavioral Medicine

, Volume 38, Issue 2, pp 318–326 | Cite as

How risky is it to use e-cigarettes? Smokers’ beliefs about their health risks from using novel and traditional tobacco products

  • Jessica K. PepperEmail author
  • Sherry L. Emery
  • Kurt M. Ribisl
  • Christine M. Rini
  • Noel T. Brewer


We sought to understand smokers’ perceived likelihood of health problems from using cigarettes and four non-cigarette tobacco products (NCTPs: e-cigarettes, snus, dissolvable tobacco, and smokeless tobacco). A US national sample of 6,607 adult smokers completed an online survey in March 2013. Participants viewed e-cigarette use as less likely to cause lung cancer, oral cancer, or heart disease compared to smoking regular cigarettes (all p < .001). This finding was robust for all demographic groups. Participants viewed using NCTPs other than e-cigarettes as more likely to cause oral cancer than smoking cigarettes but less likely to cause lung cancer. The dramatic increase in e-cigarette use may be due in part to the belief that they are less risky to use than cigarettes, unlike the other NCTPs. Future research should examine trajectories in perceived likelihood of harm from e-cigarette use and whether they affect regular and electronic cigarette use.


Electronic cigarettes Electronic nicotine delivery systems Tobacco products Risk perceptions Health behavior 


Conflict of interest

Drs. Jessica Pepper, Sherry Emery, Kurt Ribisl, Christine Rini, and Noel Brewer declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Jessica K. Pepper
    • 1
    • 2
    Email author
  • Sherry L. Emery
    • 3
  • Kurt M. Ribisl
    • 1
    • 2
  • Christine M. Rini
    • 1
    • 2
  • Noel T. Brewer
    • 1
    • 2
  1. 1.Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillUSA
  2. 2.Department of Health Behavior, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  3. 3.Institute for Health Research and PolicyUniversity of Illinois at ChicagoChicagoUSA

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