How did beliefs and perceptions about e-cigarettes change after national news coverage of the EVALI outbreak?

PLoS One. 2021 Apr 30;16(4):e0250908. doi: 10.1371/journal.pone.0250908. eCollection 2021.


Introduction: Exposure to media content can shape public opinions about tobacco. In early September 2019, the outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) became headline news in the United States.

Methods: In August and September 2019, we conducted two cross-sectional online surveys with current and former smokers assessing attitudes and beliefs about e-cigarettes. Study one (n = 865) was collected before the EVALI outbreak was widely covered and study two (n = 344) was collected after the outbreak had become nation-wide news. We examined differences in perceptions and beliefs between time points.

Results: E-cigarette harm perceptions increased between study one (mean = 2.67) and study two (mean = 2.90, p < .05). Ever-users of e-cigarettes largely account for this change. Endorsement of the belief that e-cigarettes were risky and more likely to cause lung damage compared to cigarettes increased between studies (p < .05). Seventy eight percent of participants at study two were aware of the vaping illness story. Being aware of the story was associated with more endorsement of the belief that e-cigarettes were risky to use, but not that using e-cigarettes would make the participant more likely to get damaged lungs.

Discussion: When the stories about the health and safety of tobacco products dominate the public information environment, it presents an opportunity to change beliefs that are frequently targeted by paid health campaigns. Changes in participant's perceptions of e-cigarettes were associated with coverage of this large news story, underscoring the importance of working to ensure that coverage is a scientifically accurate as possible.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cross-Sectional Studies
  • Disease Outbreaks / statistics & numerical data*
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Lung Injury / epidemiology*
  • Lung Injury / pathology
  • Lung Injury / psychology
  • Male
  • Mass Media / statistics & numerical data*
  • Middle Aged
  • Perception
  • Surveys and Questionnaires
  • Tobacco Products / adverse effects*
  • United States / epidemiology
  • Vaping / adverse effects*
  • Vaping / psychology