12.6.8 Perceptions of additives among the community
Most Australians understand that the use of tobacco products is dangerous and causes disease such as cancer. But many do not have an accurate understanding of how these diseases are caused and the relative risks of damage from additives, nicotine, unburned and burned tobacco.1
An Australian study in 2006 2 reported that respondents in focus groups were surprised to learn what the tobacco industry actually adds to cigarettes and why. Some respondents were sceptical that additives are ‘ordinary’ substances, such as chocolate and sugar, rather than frightening ones, such as ‘jet fuel.’ Some smokers seek out so-called ‘natural’ or ‘chemical free’ cigarettes. Many roll-your-own smokers believe that roll-your-own tobacco is more ‘natural’ than factory-made cigarettes and does not contain additives, and is therefore less harmful.3,4 However, roll-your-own tobacco contains similar additives as ready-made cigarettes and exposes users to the same toxins/carcinogens as ready-made cigarette smokers.5,6
An Australian study from 2021 found that while some people understood that the burning process produced most of the harmful chemicals from smoking (consistent with the evidence), most smokers or recent quitters believed that products with more additives would be more harmful (inconsistent with the evidence).7 In a similar study, most Australians were unable to predict the relative risks of damage from burning tobacco (highest risk), unburned tobacco, additives and nicotine (lowest risk).1
The popular American brand Native American Spirit (owned by a major tobacco company with no affiliation to Native Americans)8 uses health-oriented marketing such as “100% additive-free natural tobacco”.9 Nearly 64% of people who use this product inaccurately believed that it was less harmful than other brands.10
References
1. King B, Borland R, Yong HH, Gartner C, Hammond D, et al. Understandings of the component causes of harm from cigarette smoking in australia. Drug and Alcohol Review, 2019; 38(7):807-17. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31691407
2. Carter SM and Chapman S. Smokers and non-smokers talk about regulatory options in tobacco control. Tobacco Control, 2006; 15(5):398-404. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16998175
3. Filippidis FT, Driezen P, Kyriakos CN, Katsaounou P, Petroulia I, et al. Transitions from and to roll-your-own tobacco, perceptions and health beliefs among smokers: Findings from the EUREST-PLUS ITC Europe surveys. European Journal of Public Health, 2020; 30(Suppl_3):iii18-iii25. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32267933
4. Young D, Borland R, Hammond D, Cummings KM, Devlin E, et al. Prevalence and attributes of roll-your-own smokers in the international tobacco control (ITC) four country survey. Tobacco Control, 2006; 15 Suppl 3(Suppl 3):iii76-82. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16754951
5. Laugesen M, Epton M, Frampton CM, Glover M, and Lea RA. Hand-rolled cigarette smoking patterns compared with factory-made cigarette smoking in New Zealand men. BMC Public Health, 2009; 9(1):194. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19538719
6. Shahab L, West R, and McNeill A. A comparison of exposure to carcinogens among roll-your-own and factory-made cigarette smokers. Addiction Biology, 2009; 14(3):315-20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19523045
7. King B, Borland R, Morphett K, Gartner C, Fielding K, et al. 'It's all the other stuff!' How smokers understand (and misunderstand) chemicals in cigarettes and cigarette smoke. Public Understanding of Science, 2021; 30(6):777-96. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33627027
8. Epperson AE and Prochaska JJ. Native owned and grown or demeaning and offensive? American indian adults' perspectives on natural american spirit branded cigarettes. Tobacco Control, 2023; 32(3):393-6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34599085
9. Epperson AE, Henriksen L, and Prochaska JJ. Natural American Spirit brand marketing casts health halo around smoking. American Journal of Public Health, 2017; 107(5):668-70. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28398789
10. Pearson JL, Johnson A, Villanti A, Glasser AM, Collins L, et al. Misperceptions of harm among natural american spirit smokers: Results from wave 1 of the Population Assessment of Tobacco and Tealth (PATH) study (2013-2014). Tobacco Control, 2017; 26(e1):e61-e7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27924008