Vapers Still Trust CDC and FDA According to New Research

Vaping is much safer than smoking. Along with the Royal College of Physicians and Public Health England, the National Academies of Sciences, Engineering, and Medicine recently released a report saying it too. We aren’t at the point where we can be absolutely certain about the precise level of risk, but the evidence is quite clear that vaping is substantially safer than smoking.

So why doesn’t the public know it? Research from the U.S. and the U.K. shows that most people don’t know that vaping is safer than smoking. Even more troubling, the perceptions of risk are moving in the wrong direction.

It’s a pretty sorry state of affairs, but a new paper may shed some light on the issue. The research looks at who people trust when it comes to information on vaping, as well as how that links to their worldviews, their views on how dangerous vaping is, and whether they vape.

The study shows that people trust the CDC, health experts and the FDA most, raising important questions about whether they’re doing enough to make sure the public understands the crucial facts about vaping.

Spoiler: they really aren’t doing enough.

The public, at large, theoretically trusts the right people but in practice is actually getting it totally wrong.

The paper starts out with an important point: information about the risks of vaping is contradictory, to say the least. On one hand you have vapers, manufacturers, and even tobacco companies saying that vaping is much safer than smoking, and on the other hand public health groups have wildly varying views, from positive to skeptical to outright hostile.

For the individual trying to assess the risk, it’s widely known that who they trust matters. You go with what you view as the most reliable source to save yourself the hard work and be more likely to get what you think will be the right answer.

So the researchers set out to figure who people saw as the most reliable sources of information. They used data from a 2015 survey of risk perceptions and tobacco products, and ended up with a sample of 4,415 adults representative of the U.S. population.

They asked them to rate their level of trust in health experts and scientists, the FDA, the CDC, tobacco companies, vaping companies, vape store employees, and the media when it comes to the health effects of vaping.

They also asked them about their worldviews (because people with an individualistic or hierarchical worldview are usually more likely to favor sources endorsing low risk), their vaping and smoking status, how dangerous they think e-cigarettes are, whether they’ve seen advertisements for vaping products, and some general demographic information.

The public trusts these experts because on most other issues they’ve been proven right.

The researchers found that no group was trusted more than “somewhat,” with the maximum trust score being 0.69 on a scale from −2.0 to +2.0 (strongly distrust to strongly trust). For the whole sample, the groups were ranked in this order:

1. The CDC (0.69)
2. Health experts (0.62)
3. The FDA (0.31)
4. News media (−0.54)
5. Vape store employees (−1.06)
6. Vape companies (−1.16)
7. Tobacco companies (−1.25)

There was a bit of variation when the participants were broken down into sub-groups. For example, current vapers trusted health experts more than they did the CDC — and they were less distrustful of vape companies, tobacco companies, vape store employees, and the media. Overall, though, the same patterns persisted. People with hierarchical and individualistic worldviews were less trusting of health experts, the CDC, the FDA and the media, and more trusting of manufacturers, but as Carl Phillips points out, the complicated system for categorizing these beliefs make this a little difficult to interpret.

One other interesting part of the paper is how the trust in different groups correlated with beliefs about the risks of vaping and the likelihood of using e-cigarettes. Overall, people who trusted industry more thought there was less risk from vaping, but there was more uncertainty about the risk in this group too. They were also more likely to vape or have vaped in the past.

Strangely, trust in public health or the media wasn’t associated with how dangerous people thought vaping was, although people who trusted the media were less likely to vape. However, it’s important to note that the study design didn’t allow the researchers to make any claims about causality, just to identify associations.

On the whole, the paper probably reflects something we basically knew anyway. People likely choose which sources to trust based on their political beliefs, and these beliefs also skew them towards a low-risk or high-risk view of vaping. However, how trust is distributed does point to a potential way to improve public perceptions of vaping.

The ranking of the most-trusted to least-trusted groups for information about vaping doesn’t make for pleasant reading. The CDC or FDA rarely say anything positive about vaping, and health experts in the U.S. are largely negative about it too, although the recent National Academies report shows some positivity. The media is slightly mistrusted but is generally hyperbolic about vaping and usually negative. It’s safe to say that these most-trusted groups aren’t doing the public perception of vaping any good.

On the opposite side of the spectrum, the least trusted sources – the tobacco industry, vaping industry, and vape store employees – are the ones most likely to tell the truth that vaping is much safer than smoking. The general mistrust of these sources is understandable, but combined with the widespread misinformation from trusted sources it’s a dangerous mix. The public, at large, theoretically trusts the right people but in practice is actually getting it totally wrong.

The problem here isn’t really with the public; it’s with the organizations they’ve put their trust in.

The only good news is that it’s clear how things can be improved, at least a little. The CDC, health experts, and the FDA need to do a lot better when it comes to informing the public about the benefits and potential risks of vaping. Accurate information should be paramount, and science should come first every time. This might be asking a little much, but the U.K. has been a great example of how to do this for several years now.

The public trusts these experts because on many other issues they’ve been proven right. The CDC, for example,is widely respected for its work on communicable diseases. The problem here isn’t really with the public; it’s with the organizations they’ve put their trust in. Like Public Health England has done, the CDC should be very clear about the fact that vaping is much safer than smoking, and health experts in the U.S. should follow suit.

We know from the U.K. – where risk perceptions are still moving in the wrong direction despite honesty from the public health organizations – the media and other factors are important too. But it should be obvious that the most trusted groups should be putting the facts first, every time. Anything else is a betrayal of the public’s trust, and ethically questionable when you consider how a smoker considering switching to vaping will make their decision. We’re unlikely to get more responsible media reporting on the issue, but the CDC, FDA, and health experts should look at the results of this study and think long and hard about the message that they’re sending.

The public trusts them, but right now they’re failing.