Changes in Harm Perceptions of E-cigarettes Compared with Cigarettes Following the Announcement of t

Jackson SE, Brown J, Kimber C, East K, MRes EB, Cox S.
Changes in Harm Perceptions of E-cigarettes Compared with Cigarettes Following the Announcement of the Disposable Vape Ban in Great Britain
Nicotine Tob Res. 2026 Feb 12:ntag030. doi: 10.1093/ntr/ntag030. Epub ahead of print. PMID: 41674155.

Introduction: E-cigarettes ('vapes') are less harmful than cigarettes and effective for smoking cessation. However, public perceptions of their relative harms have worsened over the past decade. In January 2024, the UK government announced a forthcoming ban on disposable e-cigarettes, which received extended media coverage. Concerns were raised that this could exacerbate negative harm perceptions.

Methods: We conducted a repeat cross-sectional study using monthly data from the Smoking Toolkit Study (January 2022-June 2025, the month the ban was implemented). Segmented regression models assessed changes in relative harm perceptions of e-cigarettes vs. cigarettes before and after the January 2024 announcement. Participants were 16,489 people (≥16y) in Great Britain who smoked.

Results: Trends in harm perceptions changed following the announcement of the ban on disposable e-cigarettes. Between January 2022 and January 2024, the proportion who believed e-cigarettes were less harmful declined (RR=0.804 [95%CI=0.764-0.846]), while those believing e-cigarettes were more (RR=1.300 [1.226-1.379]) or equally harmful (RR=1.078 [1.033-1.124]) increased, and the proportion unsure decreased (RR=0.859 [0.805-0.917]). Following the policy announcement, the decline in less harmful perceptions and increase in more harmful perceptions both decelerated significantly (post-announcement trends: RR=0.922 [0.806-1.055]; RR=1.073 [0.939-1.227]). By June 2025, 18.7% [17.1-20.5%] believed e-cigarettes were less harmful, 31.3% [29.1-33.7%] more harmful, 37.5% [35.5-39.6%] equally harmful, and 12.5% [10.9-14.3%] were unsure.

Conclusions: Concerns that the UK government's 2024 vaping policy announcement would exacerbate worsening trends in negative harm perceptions of e-cigarettes among people who smoke appeared unfounded: the rate of deterioration in harm perceptions actually slowed significantly to June 2025. However, harm perceptions still declined, albeit more slowly, and a large proportion of people who smoke continue to hold misperceptions about the relative harms of e-cigarettes.

Implications: Misperceptions about the relative harms of e-cigarettes remain common among people who smoke in Great Britain. The slowing of negative trends following the disposable ban announcement suggests the policy announcement did not worsen deteriorating harm perceptions as feared. Nonetheless, with only one in five adults who smoke recognising that e-cigarettes are less harmful than cigarettes, clear communication from public health bodies, government, and via the media is needed to address ongoing misconceptions. Future research should assess whether implementation of the ban in June 2025 has different effects on harm perceptions.