Unpacking Smokers’ Beliefs About Addiction and Nicotine: A Qualitative Study

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Evidence suggests that consumers correctly identify nicotine as addictive; however, many may also harbor misconceptions about its harmfulness. The majority of this evidence is based on survey data, however, which may be prone to some limitations. In the current study, we employed qualitative methods to examine, in their own words, smokers’ beliefs about nicotine and addiction. Twelve 1-hr focus groups were conducted in 3 cities in the United States (Columbus, OH; New Orleans, LA; and Washington, DC) from October to November, 2014. Adult cigarette smokers (N = 108), defined as those who reported smoking cigarettes on every day or some days, were segmented by age group (18–25 years and ≥26 years) and tobacco-use behavior. Thematic, in-depth analysis of focus-group discussion transcripts was conducted. Participant demographic information was recorded. Results showed that smokers identify nicotine as a cause of addiction to cigarettes; however, they also attribute their addiction to other factors. When asked about nicotine’s effects on the body, immediate physiological effects of smoking (e.g., stimulation, relaxation) were top of mind. Opinions varied in terms of whether nicotine itself was harmful or harmless; many were unsure and/or had not considered this question. Discussions revealed heterogeneity in smokers’ beliefs as well as recognition of their own uncertainty and lack of knowledge. The current findings provide insight that smokers may not be as misinformed regarding the relative harms of nicotine and tobacco, as has been suggested by quantitative evidence. Implications for future research are discussed.

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