{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:56:59Z","timestamp":1781265419167,"version":"3.54.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Intern Emerg Med"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>U.S. healthcare providers (HCPs) are a valuable source of information about the health impact of using tobacco products and the health benefits of quitting cigarette smoking\u00a0thus it is important to understand their perceptions of the absolute and relative risks of tobacco and nicotine-containing products (TNPs). The study objectives were to assess: (a) HCP perceptions about the relative risks of TNPs; (b) how much of the risk of smoking cigarettes HCPs attribute to combustion versus other factors; and (c) whether HCPs believe that partial or complete switching from cigarettes to using other TNPs can reduce health risks. A 15\u00a0min self-administered online survey was completed by 700 HCPs enrolled in a national online panel. Mean overall health risk ratings on a 100-point scale differ significantly for cigarettes (95.9), e-cigarettes (79.5), smokeless tobacco (76.4), nicotine pouches (60.3), and nicotine replacement therapy (40.3). HCPs attribute less than 40% of the risk of lung cancer associated with smoking cigarettes to combustion. Half of HCPs do not believe that switching completely from cigarettes to e-cigarettes or smokeless tobacco can reduce health risks. These findings indicate that HCPs are aware that not all TNPs present the same health risks, but that their perceptions of the relative risks of combustible and non-combustible products are not consistent with published estimates from authoritative sources. HCPs are generally unaware that the smoke from burning tobacco is the primary source of risk associated with cigarette smoking and most do not believe that switching completely from cigarettes to e-cigarettes or smokeless tobacco products can reduce health risks. Together,\u00a0these findings suggest that many HCPs do not have accurate information about the relative risks of non-combustible TNPs and that broadening awareness about the harm reduction associated with those products is a vital step to ensuring that HCPs can provide their patients who smoke with accurate information about the benefit of switching completely from cigarettes to other types of non-combustible TNPs.<\/jats:p>","DOI":"10.1007\/s11739-026-04321-1","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T14:47:54Z","timestamp":1776091674000},"page":"1325-1333","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["U.S. healthcare provider risk perceptions of tobacco and nicotine-containing products"],"prefix":"10.1007","volume":"21","author":[{"given":"Susan","family":"Martelle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deena","family":"Battista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2025-7140","authenticated-orcid":false,"given":"Michael","family":"Polster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"4321_CR1","unstructured":"U.S. Food and Drug Administration (2024) FDA authorizes marketing of four menthol-flavored e-cigarette products after extensive scientific review. U.S. Food and Drug Administration. https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-authorizes-marketing-four-menthol-flavored-e-cigarette-products-after-extensive-scientific. Accessed 29 Jan 2025"},{"key":"4321_CR2","unstructured":"Center for Tobacco Products. The relative risks of tobacco products. U.S. Food and Drug Administration. https:\/\/www.fda.gov\/tobacco-products\/health-effects-tobacco-use\/relative-risks-tobacco-products. Accessed 29 Jan 2025"},{"key":"4321_CR3","unstructured":"(2018) Stratton KR, Kwan LY, Eaton DL, eds. Public Health Consequences of E-Cigarettes. National Academies Press. https:\/\/nap.nationalacademies.org\/catalog\/24952\/public-health-consequences-of-e-cigarettes. Accessed 29 Jan 2025"},{"issue":"10","key":"4321_CR4","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1111\/add.16258","volume":"118","author":"OA Wackowski","year":"2023","unstructured":"Wackowski OA, Bover Manderski MT, Gratale SK, Weiger CV, O\u2019Connor RJ (2023) Perceptions about levels of harmful chemicals in e-cigarettes relative to cigarettes, and associations with relative e-cigarette harm perceptions, e-cigarette use and interest. Addiction 118(10):1881\u20131891. https:\/\/doi.org\/10.1111\/add.16258","journal-title":"Addiction"},{"key":"4321_CR5","doi-asserted-by":"publisher","unstructured":"Tran TPT, Tran TTH, Phan TH, Hoang VM, Popova L (2025) Perceived harm of e-cigarettes relative to conventional cigarettes: comparison among different measures in the US and Vietnam. Addict Behav 162:108230.\u00a0https:\/\/doi.org\/10.1016\/j.addbeh.2024.108230","DOI":"10.1016\/j.addbeh.2024.108230"},{"key":"4321_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-020-00410-2","author":"L Malt","year":"2020","unstructured":"Malt L, Verron T, Cahours X et al (2020) Perception of the relative harm of electronic cigarettes compared to cigarettes amongst US adults from 2013 to 2016: analysis of the population assessment of tobacco and health (PATH) study data. Harm Reduct J. https:\/\/doi.org\/10.1186\/s12954-020-00410-2","journal-title":"Harm Reduct J"},{"issue":"12","key":"4321_CR7","doi-asserted-by":"publisher","first-page":"3888","DOI":"10.1007\/s11606-020-06172-8","volume":"36","author":"MB Steinberg","year":"2020","unstructured":"Steinberg MB, Bover Manderski MT, Wackowski OA, Singh B, Strasser AA, Delnevo CD (2020) Nicotine risk misperception among US physicians. J Gen Intern Med 36(12):3888\u20133890. https:\/\/doi.org\/10.1007\/s11606-020-06172-8","journal-title":"J Gen Intern Med"},{"issue":"4","key":"4321_CR8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.6692","volume":"5","author":"CD Delnevo","year":"2022","unstructured":"Delnevo CD, Jeong M, Teotia A et al (2022) Communication between US physicians and patients regarding electronic cigarette use. JAMA Netw Open 5(4):e226692. https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.6692","journal-title":"JAMA Netw Open"},{"key":"4321_CR9","unstructured":"Koplow B (2025) Keynote Address. In: FDLI Tobacco and Nicotine Products Regulation and Policy Conference. Washington"},{"key":"4321_CR10","unstructured":"SAS Institute Inc. Base SAS (Version 9.4) Published 2016. Available from: https:\/\/www.sas.com\/en_us\/software\/sas9.html"},{"key":"4321_CR11","unstructured":"SAS Institute Inc. SAS\/STAT\u00ae\u00a015.3 User\u2019s Guide. Published 2023. Available from: SAS Institute Inc."},{"issue":"3","key":"4321_CR12","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.amepre.2023.03.009","volume":"65","author":"AF Harlow","year":"2023","unstructured":"Harlow AF, Xie W, Goghari AR et al (2023) Sociodemographic differences in e-cigarette uptake and perceptions of harm. Am J Prev Med 65(3):356\u2013365. https:\/\/doi.org\/10.1016\/j.amepre.2023.03.009","journal-title":"Am J Prev Med"},{"key":"4321_CR13","unstructured":"https:\/\/www.fda.gov\/tobacco-products\/ctp-newsroom\/notice-funding-opportunity-public-health-communication-messaging-about-continuum-risk-tobacco. 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D.B. is employed by Womble Bond Dickinson and is currently on full-time assignment with RAI Services Company. M.P. is a full-time employee of NAXION, the company with which RAI Services contracted to conduct the study. RAI Services Company is a wholly owned subsidiary of Reynolds American Inc., which is a wholly owned subsidiary of British American Tobacco.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was submitted to the Western Institutional Review Board and was deemed to be exempt in accordance with the Code of Federal Regulations, 45CFR Part 46. All participants were shown an Informed Consent Statement and consented to participate in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}