Risk Perceptions of E-Cigarettes and the Evaluation of EVALI Messaging

Lawrence Jin, Donald Kenkel, Alan Mathios (), Grace N. Phillips, Revathy Suryanarayana and Hua Wang

No 35724, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: With the growth of sales of e-cigarettes and other alternative nicotine products, governments face the new challenge of crafting public health messages that provide information to consumers about these less risky but not risk-free products. Bayesian learning serves as the theoretical framework for our analysis of how smokers form their perceptions of the risks of e-cigarettes based on the risks of smoking. This paper consists of two parts. First, we conduct a cross-country descriptive analysis of government messaging and smokers’ perceptions of e-cigarette risks. We study a diverse group of eight countries: Australia, China, Indonesia, Japan, Malaysia, Sweden, the U.K. and the U.S. We find that public health messages range widely across the countries. In online cross-country surveys of adult smokers, on average perceptions of e-cigarette risks are associated with their perceptions of the risk of smoking and with their countries’ messaging. Notably, in all eight countries many smokers incorrectly believe that e-cigarettes are relatively more harmful than smoking and over-estimate the absolute risks of e-cigarettes. In the second part of our study, we report the results of online randomized experiments that compare the effects of different e-cigarette risk messaging about an outbreak of lung injuries (given the acronym EVALI). The U.K. public health message about the low risk of e-cigarettes relative to smoking reduced smokers’ incorrect risk perceptions, while the U.S. public health message increased incorrect risk perceptions.

JEL-codes: I12 I18 (search for similar items in EconPapers)
Date: 2026-09
Note: EH
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