Safer Solutions: How Misinformation Impacts Perception and Policy
This is the third edition of a five-part series on risk misperception. To read more, click here.
“There’s a chance that an ingredient in sunscreen could be causing cancer.” A TikTok creator with 1.2 million followers made this false statement recently. Recently, high-profile and small social media accounts alike have shared false claims that sunscreen is riskier than sun exposure. And they’re having an impact: One survey found that 14 percent of adults under age 35 now think daily sunscreen use “is more harmful to the skin than direct sun exposure.” The problem with that belief? About 90 percent of nonmelanoma skin cancers are associated with ultraviolet radiation from the sun, and having five or more sunburns in one’s lifetime doubles their risk for melanoma.
Sunscreen is a simple form of harm reduction. Rather than hiding from the sun at all times, we use sunscreen to reduce our health risks. But the recent spread of false claims about sunscreen—and the impacts of those claims on people’s behavior—reveal how misinformation can cause people to avoid using tools that are proven to reduce the risk of harmful behaviors.
We face similar misinformation problems with nicotine, the addictive chemical in tobacco. As one of the more well-known chemicals in cigarettes, nicotine is what many people incorrectly assume makes cigarettes so deadly. In reality, out of more than 7,000 chemicals in tobacco smoke, about 70 are “directly linked to cancer”—but nicotine is not one of them. Other chemicals, created by burning tobacco, cause the smoking-related illnesses that kill nearly 500,000 Americans every year.
Although smoking rates have decreased significantly in the United States, including among youth, 28.8 million Americans still smoke, and many struggle to quit or do not plan to do so. Nicotine contributes to this struggle. It has been said that “people smoke for nicotine but they die from the tar.” Nicotine’s addictive properties and its relative safety to users are why pharmaceutical companies developed nicotine replacement therapy (NRT) products like nicotine patches and gums to aid with quitting. However, only about six of 100 people who try to quit using NRT will succeed compared to four of 100 who try to quit without pharmaceutical assistance. If the goal is to further decrease smoking rates and save lives, additional options are necessary. While not risk-free, commercial products that deliver nicotine without burning tobacco present an opportunity to reduce smoking-related harm. Electronic cigarettes, nicotine pouches, snus, and other nicotine-containing products accomplish just this.
Yet getting these products to be seen as a safer option and a potential route to smoking cessation has been an uphill battle. There are persistent misperceptions in the medical community about nicotine’s harmfulness. In one survey, more than 80 percent of U.S. primary care doctors and OBGYNs agreed with the false statement that nicotine causes cancer. Similarly, in a large national survey, 51 percent of adults agreed with the incorrect statement that “nicotine is the substance that causes most of the cancer caused by smoking.” This widespread misperception of risk could affect how doctors counsel their patients who smoke tobacco and discourage people from switching to a smoke-free nicotine product.
Compounding the problem, journalists, public health authorities, and politicians frequently disparage smoke-free nicotine products, portraying them as equally dangerous to combustible cigarettes. Although the healthiest option for people (especially young people) who do not smoke is not to use any tobacco products, sharing misleading information about the relative risks of smoke-free products can lead the public to incorrectly believe that these products are more harmful than smoking, when the reverse is true. Such perceptions can encourage policymakers to make reduced-risk products more difficult to obtain than cigarettes via sales bans, tax structures to make smoke-free products more expensive than cigarettes, and bans on flavored products that many adults say can help them quit smoking.
No one is completely immune to the effects of misinformation, especially when it’s repeated by multiple sources. This is why authoritative messengers must communicate accurate, nuanced information about relative risks.
We’re Chelsea Boyd (cboyd@rstreet.org) and Jessica Shortall (jshortall@rstreet.org), the lead authors of this Safer Solutions newsletter. Please reach out to us if you have comments or suggestions for future topics we can cover.