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    Why are Americans ill-informed about nicotineâ??s risks?
    Jonathan Foulds, PhD posted:
    If you want to see whether you are more knowledgeable than someone from another country (or your own), I would suggest you take my little 2-question quiz (probably below nearby) before reading this article.
    An interesting paper was recently published by Dr Ron Borland (Cancer Council Victoria, Aus.) and colleagues on the beliefs about the harmfulness and use of stop smoking medications and smokeless tobacco in adult smokers in four countries (Canada, USA, UK and Australia). Questions about these issues were asked to a total of over 21,200 smokers from 2002 to 2009. Among the questions asked were the following:
    Q1"As far as you know, are nicotine replacement medications (NRTs, like the nicotine patch or nicotine gum) less harmful than smoking cigarettes?
    Q2"As far as you know, are smokeless tobacco products which are not burned but instead are usually put in the mouth (like snuff, chew, or snus) less harmful than ordinary cigarettes?"
    The correct answer to both these questions is "yes, a lot less harmful".
    Q3. "The nicotine in cigarettes is the chemical that causes most of the cancer, true or false?"
    The correct answer is "false".

    American smokers were consistently less likely to answer Q1 correctly than smokers in any of the other 4 countries, and their knowledge did not improve much over time. For example, only about one in three US smokers answered correctly, whereas over 60% of UK smokers answered correctly in 2008.

    US smokers were even worse on Q2, with less than 15% answering correctly at each point, lower than any other country, with 40% of UK smokers answering correctly in 2008.

    On question 3, smokers in the different counties were equally ill-informed, with less than 50% correctly stating that nicotine is not the chemical in cigarettes that causes cancer.

    The authors of the study concluded that smokers remain misinformed about the relative safety of nicotine and tobacco products. They also commented on the bizarre situation whereby smokers in countries where smokeless tobacco is not available (UK and Australia) appear to be better informed about the relative harmfulness of smokeless tobacco than smokers in countries where it is available (USA, Canada). Unfortunately, one potential explanation for this pattern of results is that in countries where smokeless tobacco is available, public health educators have (over)reacted by misinforming the public by exaggerating the harmfulness of smokeless tobacco. It remains to be seen whether the recent FDA regulation of tobacco will result in correction of these misunderstandings. However, given that FDA recently introduced large pictorial health warnings on smokeless tobacco prior to it appearing on cigarette packs, this seems unlikely. The unfortunate consequence of failure to properly inform smokers of the relative risks of different nicotine products is that the most harmful products â?¦cigarettes, continue to dominate the nicotine market.

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