Perceptions of the relative harm of e-cigarettes among adults in Ukraine, Georgia and Kazakhstan

May 2023
The long-term health effects of e-cigarettes are still unknown, a comprehensive review has shown that for adult smokers, a switch to e-cigarettes would impose substantially less harm than continuing cigarette smoking. However, despite the growing scientific evidence, the risk communication of different tobacco and nicotine products was largely left in the hands of the media and public health authorities, which focus more on the absolute rather than relative harm.

The perception of the relative risks associated with the use of new tobacco products, such as e-cigarettes, may significantly influence the patterns of use and quitting smoking. Therefore, it is crucial to understand the relative risk perception of e-cigarettes compared to cigarettes. This study examines whether and to what extent the perceived relative harm of e-cigarettes compared with cigarettes has changed during February 2021 and
December 2022 in Ukraine, Georgia and Kazakhstan. The results of the nationally representative Omnibus surveys conducted by NGO Healthy Initiatives indicate that the perception of e-cigarettes as more harmful than cigarettes or absence of the knowledge on relative risks is dominates in Ukraine, Georgia and Kazakhstan.

Our findings emphasize the necessity for dissemination of correct scientific evidence regarding the harms associated with vaping. Also, it is important to clearly distinguish the absolute harm and relative harm of e-cigarettes when communicating with consumers.

This survey was funded with a grant from the Foundation for a Smoke-Free World, Inc. (“FSFW”), a US nonprofit 501(c)(3), independent global organization.

This survey is, under the terms of the grant agreement with FSFW, editorially independent of FSFW. The contents, selection and presentation of facts, as well as any opinions expressed herein, are the sole responsibility of the authors and under no circumstances should they be regarded as reflecting the positions of FSFW.

For more information about the Foundation for a Smoke-Free World, please visit its website (

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