Our recent survey of nearly 2,000 U.S. adults aged 21+ points to major gaps in how many adults understand nicotine and perceive the risks of different tobacco and nicotine products. No nicotine-containing product is risk-free, but the results suggest that many adults overattribute smoking-related disease to nicotine itself and have uneven views of the relative risks of combustible and non-combustible nicotine products.

The survey included 1,973 U.S. adults aged 21+ and was conducted February 13–16, 2026. Respondents were grouped by their primary nicotine product. Snus and other smaller groups are not shown below because sample sizes were too small; together, those excluded groups accounted for 31 respondents:

One of the most striking findings is how differently each group perceives the relative harm of nicotine products compared to cigarettes.

Vapers were most likely to say vaping is less harmful than smoking. Cigarette smokers, however, were more likely to believe vaping is worse than smoking, showing a risk perception gap that may shape how adults view smoke-free alternatives.

Nicotine pouch users were the most likely to view pouches as less harmful than cigarettes. By contrast, nearly half of non-users said pouches carry the same risk as cigarettes.

Perhaps the most important finding involves what people believe to be true about nicotine and health. The survey tested several common claims:

Nicotine is addictive, but the Food and Drug Administration (FDA) explains that while nicotine is what keeps people using tobacco products, “it’s the thousands of chemicals contained in tobacco and tobacco smoke that make tobacco use so deadly.” Yet about 7 in 10 non-users and cigarette smokers in this survey believed nicotine itself causes cancer.

This matters because approximately 25 million American adults still smoke cigarettes, and risk communication about tobacco products can be difficult to understand. 

Non-users were significantly less likely to feel informed about nicotine and health—and they were also the least likely to seek information.

In this survey, one-third of non-users said they do not actively seek health information about nicotine products—yet this group also held some of the strongest views and highest rates of nicotine misinformation.

The surveyed adults were also asked whether they agree there is a "vaping epidemic" in the U.S. That term became common after youth e-cigarette use rose sharply in the late 2010s, peaking in 2019 at 27.5% of high school students and 10.5% of middle school students. By the 2025 National Youth Tobacco Survey, current youth e-cigarette use had fallen to 5.2% of middle and high school students overall.

All groups largely agree with the "epidemic" framing, but vapers show the most resistance—16% disagree, compared to single digits for other groups.

These findings highlight a central challenge in nicotine communication: respondents least engaged with health information often showed some of the highest rates of inaccurate or incomplete beliefs. Non-users were the most likely to believe common nicotine misstatements while also being the least likely to look for information.

For adults who smoke, confusion about comparative risk may affect how they interpret public health information about products that do and do not involve combustion. If cigarette smokers believe non-combustible products like vaping are more harmful than smoking, they may be less likely to consider using the alternative as a complete replacement for cigarettes.

Adults need clearer information about nicotine and risk. Too often, nicotine, smoke, and combustion are treated as the same issue, but they are not. Better public information can help people understand the differences without suggesting any nicotine product is risk-free.

Laura Leigh Oyler 

This survey reinforces a key public health point: accurate information matters. Inaccurate or incomplete beliefs about nicotine, smoking, vaping, nicotine pouches, and comparative risk remain common across all groups, especially among adults who do not use nicotine products and do not seek information.

For adults who currently smoke or use nicotine, understanding the differences between combustible and non-combustible products can support more informed conversations with healthcare professionals and other credible sources. For everyone else, separating nicotine myths from facts remains an ongoing challenge.

Important Disclaimer: This article is provided for informational purposes only. It does not claim that any nicotine product is safe, or that nicotine pouches or vapes are safer than cigarettes. Any reduced-risk claims require separate authorization from the U.S. Food and Drug Administration. Nicotine is addictive and intended only for adults age 21 and over. Adults considering changes to their nicotine use should consult a qualified healthcare professional.