Misconceptions About Nicotine Among People Living with HIV


Researchers at Johns Hopkins University investigated knowledge of smoking and nicotine among HIV-positive smokers in a study published online in Addictive Behaviors.

Limiting nicotine content in tobacco products can reduce dependence and overall tobacco use, and may subsequently reduce morbidity and mortality. However, the success of such measures is limited by the public’s misperceptions about nicotine's safety. Researchers at Johns Hopkins University investigated knowledge of smoking and nicotine among HIV-positive smokers in a study published online in Addictive Behaviors.

Current smokers living with HIV completed an online survey regarding demographics, tobacco use, and knowledge about smoking and nicotine. Of those surveyed, the majority were light smokers—defined as those who do not smoke daily—and nicotine dependence was low.

A majority correctly identified the chemicals in cigarette smoke, and also recognized nicotine as the addictive component. The authors noted that public health efforts to educate consumers about the dangers of smoking are working, as evidenced by the number of correct responses to their survey.

However, most participants incorrectly identified nicotine as the cause of smoking-related cancers and other morbidities. Lack of differentiation between nicotine's effects and tobacco smoke in public health campaigns may be to blame for this confusion.

The belief that nicotine is the harmful component may have repercussions. It may lead smokers to perceive that products with reduced nicotine levels are safe, create a reduced urge to quit among smokers, or even encourage former smokers to resume smoking. This misconception may even limit the success of nicotine reduction policies.

Income, education level, and cigarettes per day did not consistently correlate with knowledge the way the authors expected. For example, neither greater education nor higher income positively correlated with knowledge. The researchers concluded that additional research is needed to elucidate these associations.

Because most people living with HIV have regular contact with the medical system, ample opportunity for screening and education about smoking cessation exists. The authors called for clarification on tobacco product labels and in educational materials about the relative harm of nicotine replacement and nicotine reduction.


Pacek LR, Rass O, Johnson MW. Knowledge about nicotine among HIV-positive

smokers: Implications for tobacco regulatory science policy. Addict Behav. 2017; doi: 10.1016/j.addbeh.2016.10.008. PubMed PMID: 27792909; PubMed

Central PMCID: PMC5140741.

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