When Teens Perceive Some Smoking Products as Less Harmful Than Others, Do Their Smoking Habits Change a Year Later? :

If a teenager views cigarette smoking as not being harmful to their personal health, they are more apt to be smoking a year later. But what about other non-cigarette tobacco products?  Parker et al. (10.1542/peds.2018-1505) answer this question in a new study that analyzes data from the national Population Assessment of Tobacco and Health (PATH) Study in which youth were surveyed in 2013-2014 regarding their perceptions of harm for smoking cigarettes, e-cigarettes, cigars, pipes, hookahs, and smokeless tobacco and then were resurveyed a year later as to what if any smoking products they were using.  It will not surprise you that teens viewed combustible (i.e., conventional) cigarettes as having the most harm (84.8% of teens surveyed) and e-cigarettes as the least harm (26.6%). It may surprise you to learn that if teens at baseline viewed non-combustible tobacco products as being of no or little harm, they were more likely to try those products a year later rather than conventional cigarettes—despite the fact that these products contain nicotine and other toxins that can be just as harmful to these teens.  This study should convince you to broaden your anti-smoking strategy to not just cigarettes, or even e-cigarettes when seeing teens in the office, and assess just how harmful your patients think non-combustible tobacco products are.  It may be just what is needed to prevent those teens from embarking on a path they will have difficulty getting off of, once they start smoking any habit -forming tobacco product—and they are all habit-forming.