Perceiving E-cigarettes as Less Harmful than Cigarettes is Associated with JUUL and Vuse Solo Use Intentions among Young Adult Dual-users

Objective: In this study, we aimed to examine associations of relative harm perceptions of e-cigarettes versus cigarettes and using or switching to commonly used or FDA-authorized e-cigarettes among young adult dual-users. Methods: We conducted a cross-sectional online survey in 2022 among young adult (ages 18-34) dual-users of cigarettes and e-cigarettes (N = 1821). We used multivariable logistic regressions to examine the associations between the explanatory variable and each response variable, controlling for covariates and stratified by current JUUL or Vuse Solo use. Results: Less than half (40.6%) of the participants perceived e-cigarettes as less harmful than cigarettes. Perceiving e-cigarettes as less harmful was associated with intentions of using and completely switching to JUUL and Vuse Solo. For stratified analysis, perceiving e-cigarettes as less harmful was associated with using and completely switching to JUUL among current and noncurrent JUUL users; it was associated with having intentions of using and completely switching to Vuse Solo among non-current Vuse Solo users. Conclusions: Perceiving e-cigarettes as less harmful than cigarettes was associated with having intentions of using and completely switching to JUUL and Vuse Solo products. Increasing the accurate relative harm perception is important to promote complete product switching to e-cigarettes among young adult smokers.