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Research Article Research Article

Young adults are underestimating the dangers of nicotine

Many young adults aren’t aware of the dangers of nicotine, according to new Truth Initiative research published in BMJ Open. Nearly 1 in 3 believed nicotine to be no more harmful than a cup of coffee; 1 in 4 believed nicotine to be useful as a medical treatment for mood, attention, or memory disorders; and more than 1 in 8 believed that nicotine is only addictive when smoked from a cigarette. Researchers also found that the spread of misleading claims about nicotine, especially regarding COVID-19, is tied to holding more positive beliefs about the tobacco industry. Health misinformation, which has been rampant during the COVID-19 pandemic, can ultimately undermine public health and regulatory efforts to curb youth nicotine use.

Research shows nicotine can worsen mental health concerns including symptoms of depression and anxiety. Nicotine is addictive in its many forms, including in e-cigarettes popular with young people. “Young people who do not smoke, and in the case of those suffering from mood or attention disorders may be at heightened risk of addiction, report both seeing and believing demonstrably false or unsubstantiated information about nicotine safety that is likely to encourage use and result in lifelong addiction,” the authors write.


Nearly 1 in 3 young adults believed nicotine to be no more harmful than a cup of coffee


1 in 4 young adults believed nicotine to be useful as a medical treatment for mood, attention, or memory disorders


More than 1 in 8 young adults believed that nicotine is only addictive when smoked from a cigarette

Misperceptions about COVID-19 and nicotine

In 2020, misinformation about the rapidly evolving COVID-19 pandemic flooded online news and social media outlets. Early reports claimed that smokers were less likely to be hospitalized with COVID-19 and that nicotine prevents infection with COVID-19. Research to date does not support these supposed benefits of nicotine on the respiratory disease, instead indicating that smoking increases the odds of disease progression and severe symptoms. Vaping and using smokeless tobacco products are also likely risk factors for infection and progression of COVID-19. Another theory claimed that chemicals in vapor from e-cigarettes sterilize the air, offering protection from COVID infection. The claim was taken from a very old study and promoted as evidence to support vaping during the pandemic.

Truth Initiative researchers surveyed 1,225 young adults between 18-34 in June 2021 about belief in these claims and about basic facts about nicotine, as well as their use of specific social media platforms.

Positive views of Big Tobacco may hinder nicotine regulation

Young adults who believed or recalled distorted science about nicotine in general or related to COVID-19 were more likely to have positive perceptions of the tobacco industry. The spread of misleading claims about nicotine, especially regarding COVID-19, can undermine public health and regulatory efforts. Viewing the tobacco industry favorably can get in the way of support for regulation, one of the reasons the industry has devoted significant efforts to rehaul its reputation.

In an effort to grow their consumer base and expand to products other than cigarettes, Big Tobacco has launched a larger campaign to try to transform itself into “New Tobacco,” with offers of non-combustible tobacco product alternatives and claims that the industry can be part of the “public health solution” to end smoking. Recent industry efforts to improve their image include sponsoring entire issues of prestigious research journals and participating in tobacco control research conferences, where they present tobacco industry-sponsored research alongside independent, credible public health research, and gain critical insight into tobacco control evidence and strategy.

Social media platforms are key in spreading misinformation

Young adults who use YouTube and Twitter are more likely to believe inaccurate scientific claims about nicotine, while those who use Reddit were less likely to do so, compared to those who never used the platforms, according to the research. For instance, Twitter use was associated with 26% higher odds of belief in distorted science about nicotine, compared to those who never use Twitter. The relationship was dose-related: the greater the Twitter use, the higher the odds of recalling inaccurate science about nicotine.

Young adults who used YouTube had 32% higher odds of believing in COVID-19-specific distorted science, compared to those who never use YouTube, while those who used Reddit had 28% lower odds of believing COVID-19-specific distorted science compared to those who never used the platform.

Because researchers also found belief in distorted science is tied to positive beliefs in the tobacco industry, social media platforms present a powerful opportunity for Big Tobacco to spread disinformation that obscures science and undermines public support for tobacco policies designed to protect public health.

The need to combat misinformation about nicotine

“Although there is currently no significant evidence supporting therapeutic benefits of nicotine use, misinformation ostensibly backed by ‘science’ is being disseminated on social media and potentially facilitating good will towards the tobacco industry,” the authors write. Social media plays a critical role in spreading information and misinformation, underscoring the need for regulation of these platforms to keep misinformation about nicotine from spreading.

Given the tobacco industry’s long-documented and continuing interference in the scientific process and spreading misinformation, “…the role of the tobacco industry in disseminating this information merits close monitoring, significant counter messaging, and proactive inoculation against potentially harmful narratives,” the authors write.