Exploring the Underlying Beliefs Shaping Perceptions of E-cigarette Harm Among a Convenience Sample of Adults in the United States

Numerous explanations contribute to how individuals perceive the relative harm of e-cigarettes compared to combustible cigarettes. This study extends beyond single-item assessments of harm perception by exploring not only what people believe, but also why they hold these beliefs, and provides important context to existing survey research that use a broad relative harm measure. Participants cited both reasons related to health harms and addiction to explain their harm perceptions. These insights suggest that commonly used survey items may capture beliefs about health harm, addiction, and frequency of use. Findings from this analysis can also inform the development of new items that more precisely measure the underlying rationale for relative harm perceptions of e-cigarettes versus combustible cigarettes.