U.S. healthcare provider risk perceptions of tobacco and nicotine-containing products

U.S. healthcare providers (HCPs) are a valuable source of information about the health impact of using tobacco products and the health benefits of quitting cigarette smoking thus it is important to understand their perceptions of the absolute and relative risks of tobacco and nicotine-containing products (TNPs). The study objectives were to assess: (a) HCP perceptions about the relative risks of TNPs; (b) how much of the risk of smoking cigarettes HCPs attribute to combustion versus other factors; and (c) whether HCPs believe that partial or complete switching from cigarettes to using other TNPs can reduce health risks. A 15 min self-administered online survey was completed by 700 HCPs enrolled in a national online panel. Mean overall health risk ratings on a 100-point scale differ significantly for cigarettes (95.9), e-cigarettes (79.5), smokeless tobacco (76.4), nicotine pouches (60.3), and nicotine replacement therapy (40.3). HCPs attribute less than 40% of the risk of lung cancer associated with smoking cigarettes to combustion. Half of HCPs do not believe that switching completely from cigarettes to e-cigarettes or smokeless tobacco can reduce health risks. These findings indicate that HCPs are aware that not all TNPs present the same health risks, but that their perceptions of the relative risks of combustible and non-combustible products are not consistent with published estimates from authoritative sources. HCPs are generally unaware that the smoke from burning tobacco is the primary source of risk associated with cigarette smoking and most do not believe that switching completely from cigarettes to e-cigarettes or smokeless tobacco products can reduce health risks. Together, these findings suggest that many HCPs do not have accurate information about the relative risks of non-combustible TNPs and that broadening awareness about the harm reduction associated with those products is a vital step to ensuring that HCPs can provide their patients who smoke with accurate information about the benefit of switching completely from cigarettes to other types of non-combustible TNPs.