Trust of Information about Tobacco and E-Cigarettes from Health Professionals versus Tobacco or Electronic Cigarette Companies: Differences by Subgroups and Implications for Tobacco Messaging

Health Commun. 2020 Jan;35(1):89-95. doi: 10.1080/10410236.2018.1544875. Epub 2018 Nov 13.


Smoking behavior may be influenced by perceived trust of information from tobacco and e-cigarette companies about their products. The purpose of this study was to identify sociodemographic subgroups with more trust in tobacco product (tobacco and e-cigarette) companies than health professionals and explore associations between this relative trust and tobacco product use.Health Information National Trends Survey (HINTS 4, FDA Cycle) data were analyzed (N = 3,738). Two relative trust measures were developed identifying respondents who trust tobacco companies or e-cigarette companies as much as or more than health professionals for information about the health effects of tobacco products or e-cigarettes versus those who place more trust in health professionals. Dependent variables were smoking status (current, former, never) and e-cigarette use (ever, never). Bivariate analyses and multivariable logistic regressions were conducted in SAS 9.4 using jackknife replicate weights.Respondents who trusted tobacco or e-cigarette companies as much as or more than health professionals were disproportionately from racial/ethnic minority groups or had low levels of income or education (all p < 0.05). Relative trust was not associated with smoking status. After controlling for demographics, respondents who trusted e-cigarette companies as much as or more than health professionals had 87% greater odds (95% CI: 1.16, 3.00) of e-cigarette use, compared to respondents who placed higher trust in health professionals.Findings suggest that population subgroups with greater trust in e-cigarette companies relative to health professionals are more prone to e-cigarette use. Targeted communication strategies may be needed for underserved populations and to counter messaging from e-cigarette companies.