Risk perceptions of low nicotine cigarettes and alternative nicotine products across priority smoking populations

Rachel L. Denlinger‐apte, Lauren R. Pacek, Jennifer Cornacchione Ross, Maansi Bansal‐travers, Eric C. Donny, Dorothy K. Hatsukami, Dana Mowls Carroll

Research output: Contribution to journalArticlepeer-review


Background: As the U.S. Food and Drug Administration considers a low nicotine product standard for cigarettes, it is important to examine how people who smoke, especially individuals from priority populations disproportionately affected by smoking, perceive low nicotine content (LNC) cigarettes and their relative risk perceptions of alternative nicotine delivery system (ANDS) products, including e‐cigarettes and snus, and medicinal nicotine. Methods: Data are from Wave 4 (2016–2017) of the adult Population Assessment of Tobacco Use and Health (PATH) Study. We examined respondents’ absolute risk perceptions about nicotine, LNC cigarettes, ANDS products and medicinal nicotine; their relative risk perceptions of LNC cigarettes and ANDS products compared to conventional cigarettes; and their relative risk perceptions of medicinal nicotine compared to ANDS products. Results: The majority of respondents across priority smoking populations indicated snus, e‐cigarettes, and LNC cigarettes were ‘about the same’ level of harmfulness or addic-tiveness as conventional cigarettes. The majority of respondents indicated e‐cigarettes to be ‘about the same’ harmfulness as medicinal nicotine. Conclusions: Our study indicates that adults who smoke cigarettes generally have misperceptions about the harms of nicotine and the relative risks of ANDS products and such misperceptions exist regardless of their racial/ethnic identity, sexual orientation, and gender identity.

Original languageEnglish (US)
Article number5311
JournalInternational journal of environmental research and public health
Issue number10
StatePublished - May 2 2021

Bibliographical note

Funding Information:
Funding: This research was funded by the National Institute of Drug Abuse and the Food and Drug Administration’s Center for Tobacco Products, grant number U54DA031659 (to EC Donny and DK Hatsukami); the National Institute on Drug Abuse, grant number K01DA043413 (to LR Pacek); the National Institute on Minority Health and Health Disparities, grant number K01MD014795 (to DM Carroll); and the National Cancer Institute, grant number R03CA252767 (to RL Denlinger‐Apte). This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Ethnicity
  • E‐cigarettes
  • LGBTQ+
  • Low nicotine cigarettes
  • Nicotine
  • Race
  • Risk perceptions
  • Snus


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