The association between perceived e-cigarette and nicotine addictiveness, information-seeking, and e-cigarette trial among U.S. adults

Prev Med. 2019 Jan;118:66-72. doi: 10.1016/j.ypmed.2018.10.003. Epub 2018 Oct 11.


Perceptions of harm and addictiveness are associated with smoking combusted cigarettes, but these factors have not been fully explored for e-cigarettes. Specifically, little is known about the perceived harm and addictiveness of e-cigarettes, or whether information-seeking about e-cigarettes is related to trying e-cigarettes. We aimed to determine the relationship between (1) perceived e-cigarette harm and addictiveness and trying e-cigarettes; (2) nicotine perceptions and trying e-cigarettes; and (3) e-cigarette information-seeking, Internet use, and trying e-cigarettes. We used data from the nationally representative 2015 Health Information National Trends Survey-FDA (HINTS-FDA 2015). Weighted multivariable logistic regression models assessed independent associations between perceived e-cigarette harm, perceived e-cigarette addictiveness, nicotine perceptions, e-cigarette information-seeking, personal Internet use, and trying e-cigarettes, among 3195 adults. Compared to people who believed e-cigarettes were equally or more addictive than combusted cigarettes, those who believed e-cigarettes were less addictive had 2.49 times the odds of trying e-cigarettes (95% confidence interval [CI]: 1.30, 4.74). Perceived e-cigarette harm and nicotine perceptions were not associated with trying e-cigarettes. The positive association between e-cigarette addictiveness and trying e-cigarettes coupled with the lack of an association between nicotine perceptions and trying e-cigarettes suggests people do not fully understand that e-cigarettes contain nicotine and therefore could be addictive. People most frequently reported searching for information about potential health effects of e-cigarettes (37.9%), indicating that people are interested in learning about the potential impact of e-cigarette use on their health. People who searched for information about e-cigarettes had 10.23 higher odds of trying e-cigarettes (CI: 5.41, 19.33).

Keywords: Addictiveness perception; Electronic cigarettes; Harm perception; Health communication.

MeSH terms

  • Adult
  • Behavior, Addictive*
  • Cross-Sectional Studies
  • Electronic Nicotine Delivery Systems*
  • Female
  • Health Surveys
  • Humans
  • Information Seeking Behavior*
  • Male
  • Middle Aged
  • Nicotine / adverse effects*
  • Perception*
  • United States
  • Vaping / adverse effects*
  • Young Adult


  • Nicotine