Youths' Perceptions of Nicotine Harm and Associations With Product Use.

This article focuses on U.S. youths' perceptions of nicotine and how these perceptions relate to tobacco use, based on data from waves 4 and 4.5 of the Population Assessment of Tobacco and Health (PATH) Study. While most youth correctly identified nicotine as the main addictive substance in tobacco, a majority incorrectly believed nicotine is the primary cause of smoking-related cancer. Youth rated nicotine in cigarettes as more harmful than in e-cigarettes or nicotine replacement therapy (NRT), and higher perceived harm of nicotine was associated with lower likelihood of initiating tobacco use about one year later. However, nicotine harm perceptions did not predict switching between cigarettes and e-cigarettes among current users. The findings highlight challenges in communicating nicotine's risks accurately to youth without inadvertently encouraging tobacco use or deterring use of cessation aids like NRT.