title: US adult tobacco users' absolute harm perceptions of traditional and alternative tobacco products, information-seeking behaviors, and (mis)beliefs about chemicals in tobacco products.
abstract: Harm perceptions about tobacco products may influence initiation, continued use, and cessation efforts. We assessed associations between adult traditional tobacco product use and absolute harm perceptions of traditional and alternative tobacco products. We also described the topics individuals looked for during their last search for information, their beliefs about chemicals in cigarettes/cigarette smoke, and how both relate to harm perceptions.
  
  
  
  We ran multivariable models with jackknife replicate weights to analyze data from the 2015 administration of the National Cancer Institute's Health Information National Trends Survey (N=3376).
  
  
  
  Compared to never users, individuals reported lower perceived levels of harm for products they use. Among current tobacco users, ethnicity, thinking about chemicals in tobacco, and information-seeking were all factors associated with tobacco product harm perceptions. In the full sample, some respondents reported searching for information about health effects and cessation and held misperceptions about the source of chemicals in tobacco.
  
  
  
  This study fills a gap in the literature by assessing the absolute harm perceptions of a variety of traditional and alternative tobacco products. Harm perceptions vary among tobacco products, and the relationship among tobacco use, information seeking, thoughts about chemicals in tobacco products, and harm perceptions is complex. Data suggest that some individuals search for information about health effects and cessation and hold misperceptions about chemicals in tobacco products. Future inquiry could seek to understand the mechanisms that contribute to forming harm perceptions and beliefs about chemicals in tobacco products.
authors.affiliation: Office of Science, Division of Population Health Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, United States. Electronic address: Jennifer.Bernat@fda.hhs.gov.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Bernat
authors.affiliation: Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Ferrer
authors.affiliation: Office of Science, Division of Population Health Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, United States.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Margolis
authors.affiliation: Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Blake
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D057226:Information Seeking Behavior; D008297:Male; D008875:Middle Aged; D062789:Tobacco Products; D014029:Tobacco Use Disorder / Q000523:psychology*; D014481:United States; D055815:Young Adult
keywords: Absolute harm perceptions; HINTS; Information seeking; Tobacco