It Is About Trust: Trust in Sources of Tobacco Health Information, Perceptions of Harm, and Use of E-Cigarettes.

Introduction: Recent research has highlighted disparities in people who perceive as trustworthy sources of e-cigarette health information. Research has yet to examine if trusting a particular source of information is associated with use of e-cigarettes or perceptions of e-cigarette harm. We use a nationally representative survey of American adults to address these gaps in knowledge.

Methods: This study used data from the Health Information National Trends Survey (N = 3738). Logistic regression models were used to calculate odds of ever using e-cigarettes and perceived health harm of e-cigarettes. Trust in seven different sources of e-cigarette health information served as the independent variables. Models accounted for confounders.

Results: Trusting religious organizations "a lot" as sources of e-cigarette health information was associated with lower odds of ever using e-cigarettes and with lower odds of perceiving e-cigarettes as less harmful than conventional cigarettes. Trusting e-cigarette companies "a lot" as sources of e-cigarette health information was associated with lower odds of viewing e-cigarettes as harmful to health.

Conclusion: Trusting health information about e-cigarettes from sources in the medical or public health field was not associated with lower use of e-cigarettes or viewing e-cigarettes as more harmful. Trusting health information from e-cigarette companies yielded perceptions of e-cigarette harm that are consistent with messaging provided by these companies.

Implications: As use of e-cigarettes continues to climb, leveraging different modes of health communication will be critical to both discourage e-cigarette use among never-smokers and, potentially, to encourage use of e-cigarettes as an option to achieve smoking cessation or reduce the harm of tobacco products. Our findings suggest that religious organizations may be helpful in communicating anti-e-cigarette messages.