Young Adults' Risk Perceptions of Various Tobacco Products Relative to Cigarettes: Results From the National Young Adult Health Survey

Health Educ Behav. 2016 Jun;43(3):328-36. doi: 10.1177/1090198115599988. Epub 2015 Aug 24.


Objectives Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Method We examined risk perception responses among a nationally representative sample of young adults (age 18-34 years; n = 2,871, including tobacco and non-tobacco users) from the 2011 National Young Adult Health Survey. Results Most (57.8%) respondents believed that e-cigarettes were less risky than cigarettes. Respondents were more likely to rate combustible products hookah (24.5%) and cigars (13.9%) as being less risky compared to noncombustible snus (10%) and other smokeless tobacco (SLT) products (7.1%) relative to cigarettes. Few (2.5%) rated menthol cigarettes as less risky. For e-cigarettes, hookah, and SLT, less risky beliefs were significantly higher among ever or current versus never product users. Between 22% and 33% of all respondents believed that SLT, snus, menthol cigarettes, and cigars were more risky than cigarettes, but differences in this belief between current and nonusers of these products were small and insignificant. Younger young adults were more likely to rate e-cigarettes and hookah as being "less risky" and rate cigars and SLT as being "more risky" than older young adults. Conclusion The public's views of comparative tobacco risk perceptions vary widely by tobacco product type and age-group. While "less risky" perceptions may be associated with product use, perceptions that products are "more risky" than cigarettes may not necessarily dissuade people from their use.

Keywords: behavioral theories; health behavior; health communications; smoking and tobacco use; tobacco control and policy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Cigarette Smoking
  • Electronic Nicotine Delivery Systems*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Male
  • Perception*
  • Risk
  • Sex Distribution
  • Smoking / epidemiology
  • Smoking / psychology*
  • Smoking Water Pipes
  • Tobacco Products*
  • United States / epidemiology
  • Young Adult