According to the survey, while many smokers are aware that smoking can lead to serious health problems including lung cancer, many underestimate the risk of getting the disease from smoking. For example, two in three smokers underestimate the chance of developing lung cancer compared to a non-smoker and four in 10 incorrectly believe that developing lung cancer depends more on genes than anything else. Furthermore, the survey found that up to a third of smokers think that certain activities such as exercise and taking vitamins could "undo" most of the effects of smoking.(1)
"What is alarming about these survey findings is that so many smokers are still so misinformed," said Dr. Cheryl Healton, president and CEO of the American Legacy Foundation. "Proven cessation treatments like nicotine replacement therapy continue to be underutilized and we believe these misperceptions are partly to blame. These findings point to the fact that more needs to be done to educate and inform smokers."
Misperceptions about the effects of nicotine found in cigarettes remain at the forefront. Almost all survey respondents (81 to 86 percent) either were unsure whether, or incorrectly believed that, nicotine caused cancer, emphysema or heart attacks.(1) While smoking has been proven to cause cancer, heart disease, and lung disease, long-term use of NRTs are not known to be associated with any serious harmful effects.(2) These nicotine-related misperceptions can prevent consideration and appropriate use of smoking cessation aids such as nicotine replacement therapies (NRT).
The survey findings indicate smokers dramatically underestimate the safety and efficacy of NRT products such as the nicotine gum, patch and lozenge. More than 76 percent of smokers surveyed wrongly believe that, or do not know whether, NRTs are more addictive than cigarettes, highlighting the need for further education as cigarettes are vastly more addictive.(3,4) In fact, about half of the smokers surveyed stated they would be more likely to consider NRT if they were shown scientific evidence that prove its safety and efficacy.(1)
Other survey findings include:
- Sixty-five percent wrongly believe or are unsure whether nicotine in NRT products is more dangerous than the nicotine in cigarettes. NRT products such as the gum, patch and lozenge are designed to break the addiction and gradually wean smokers off nicotine.(3)
- Two-thirds wrongly believe or do not know if nicotine gum, patches or lozenges can cause cancer.(1) Many surveys have confirmed that there is not a link between cancer and nicotine replacement therapy.(2)
- Almost all survey respondents (92 percent) wrongly believe that, or did not know whether, smoking while wearing the nicotine patch can cause heart attacks. (1) Studies have shown that NRT such as the patch, gum or lozenge does not increase the risk of heart disease, cancer or other major health problems.(5,6)
- Of the smokers in the survey who attempted to quit in the past with NRT products, 76 percent were not using these products as directed by the product label.(1) Using the recommended amount of NRT maximizes the efficacy of these products.
"The survey reveals that when smokers try quitting with NRT they do not use enough of it or use it for as long as directed on the products label," said Bill Slivka, president of smoking control, GlaxoSmithKline Consumer Healthcare. "Study after study shows that, when used correctly, these products double a smoker's chances of quitting versus cold turkey.(7) The reality is that most smokers need some type of support when quitting smoking."
While research shows the majority of smokers try to quit "cold turkey," on any given quit attempt, only 3 to 5 percent of smokers who quit cold turkey are successful long-term.(8) Tools for cessation such as NRTs, social support, and counseling have been proven to greatly increase the chances of a successful quit attempt.(9) But the survey revealed that almost three-quarters (72 percent) of smokers surveyed believe that quitting is "just a matter of will power." (1) In reality, many smokers need support to address the addiction to nicotine and smoking. Smokers making a quit attempt should utilize resources such as counseling opportunities to help understand what to expect and how to handle the tough situations when quitting, and also consider safe and effective stop-smoking products.
NRT products such as the gum, patch and lozenge are among the first-line treatments recommended for all smokers and when used as directed, can double a smoker's chances of quitting versus cold turkey.(7) In fact, new research published by Thorax confirms NRT helps "real-world" smokers quit by doubling the odds of successfully quitting long-term and supports the findings of more than 100 randomized clinical trials.(10) NRT is extensively proven to significantly reduce cravings and other withdrawal symptoms during quitting, allowing smokers to focus on behavior change.(11) Data from more than 100 clinical trials involving more than 35,000 smokers have established a consistent safety and efficacy profile for NRT products over decades of study and use.(12)
About the survey
A survey of 900 men and women adult smokers in the U.S. was fielded in July 2007 by Richard Day Research through an online panel, screening for adults age 18 and over who smoke cigarettes every day. The data was weighted to adjust for age, ethnicity and gender using estimates from the 2006 National Health Interview Survey. The "average" respondent in the survey was 48 years of age and started smoking when they were 16 years old, smokes 20 cigarettes per day and has tried to quit three times in the past (only 16 percent of respondents have never tried to quit). The survey was conducted on behalf of The American Legacy Foundation and GlaxoSmithKline Consumer Healthcare.
(1) Survey of 900 adult smokers in the U.S. conducted by American Legacy Foundation and GlaxoSmithKline Consumer Healthcare in August 2007
(2) Molyneux. BMJ "Safety of NRT." February 2004.
(3) Benowitz NL. (1993). Nicotine replacement therapy: What has been accomplished - can we do better? Drugs, 45, 157-170.
(4) Henningfield et al., 2000. Tobacco Dependence: Scientific and Public Health Basis of Treatment. TEN, 2(1),42-46.
(5) GfK Market Measures.
(6) Kimmel SE; Berlin JA; Miles C; Jaskowiak J; Carson JL; Strom BL. Risk of acute first myocardial infarction and use of nicotine patches in a general population. J Am Coll Cardiol. 2001 Apr;37(5):1297-302.
(7) Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville, MD:
(8) Hughes et al., 1992. Smoking Cessation Among Self-Quitters. Health Psychology, 11(5), 331-334
(9) Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. 2004 Addiction, 99, 29-38.
(10) Is nicotine replacement therapy for smoking cessation effective in the "real world" Thorax online August 2007. Robert West Professor of Health Psychology Pg. 1-7
(11) FDA labeling for gum/lozenge/patch. 2005. Labels on boxes of Nicorette, Commit and Nicoderm CQ.
(12) Silagy et al. Nicotine replacement therapy for smoking cessation (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.
