A. Skepticism about the high stated magnitude of lower risk
“I don't think it seems believable. How can you say it's 95 percent less harmful than smoking cigarettes when 100 percent would be not smoking at all? Makes no sense to me. You're still putting something into your lungs….” (e-cigarette group, female smoker) “It just seems like a really, really stark difference between smoking cigarettes and vaping, and from what I know about vaping, I know that it like easily gets you an addiction, and it still exposes you to harmful chemicals. So like…95 percent less harmful is a really large difference.” (e-cigarette group, female YA) “I mean, do they actually know that, that it would be 90 percent less harmful?” (snus group, female smoker) “ …I usually just really – all tobacco products together as just equally being harmful, so just seeing that this is 90 percent less harmful, it's just surprising to me…I wouldn’t believe it at first glance no.” (snus group, female YA)
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B. Skepticism based on product unfamiliarity or perceived novelty
“I mean it's always for the reason being that knowledge wise it's only been out for a few years. How would they know already?” (e-cigarette group, male smoker) “…how do they already know that it’s not gonna be harmful to anybody? I mean, I never heard of it so how many people use this stuff? I don’t know. I just don’t get it.” (snus group, male smoker)
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C. Skepticism about the source of the cited estimates
“…Who's the scientist and who are these people?” (e-cigarette group, female smoker) “…it says less harmful, 95 percent. I don't know who came up with that. I don't know if it's necessarily true. Pretty sure it's not…” (e-cigarette group, female smoker) “…it could possibly be one of these scientists who get paid by these guys. It's impressive but I don’t know if it's believable…” (snus group, male smoker)
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D. Skepticism that claims sounds like a “sales pitch” or “marketing tactic”
“It just goes back to me thinking that ‘please buy our products’ basically.” (e-cigarette group, male smoker) “… ‘using vaping products exclusively’, that was a trigger word for me because it sounds like a marketing thing as opposed to an actual scientific fact.” (e-cigarette group, female smoker) “I feel it’s like the Tylenol commercials, when they say two out of three doctors recommends Tylenol. It’s just advertising and over exaggerations to me like they do with every product. So that doesn’t mean much to me reading that.” (snus group, female smoker)
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E. Skepticism about the terms “estimated” or “about”
“So the first word that I stopped at was estimated 'cause scientists really don't know. They're just estimating. That's a guess.” (e-cigarette group, female smoker) It sounds good, but it also says estimated… you don't want your money estimated…You don't want your paycheck estimated, so why would you want something about your health to be estimated?” (e-cigarette group, female smoker) “…why would scientists be estimating, anyway? Isn’t that their job to figure it out?”(snus group, female smoker) I don't like that they used the word ‘estimated’ and ‘about’, because it just makes it seem not believable. Like it makes it seem like kind of made that up…” (e-cigarette group, male YA)
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F. Skepticism about e-cigarette claim because of news about vaping related lung illnesses/EVALI:
“I think it's a bit hard to believe, but that just might be bias because we've seen so much of it lately on the news, but again, it's really concerning that people are using it for that short of a time, and you're having such a great health impact that that just makes me feel like, okay, so what if it is 95 percent less? There's still a big risk. People are still being harmed.” (e-cigarette group, female YA) “…I’m trying to be objective that if I didn’t hear anything in the news about what vaping does, the recent information. (e-cigarette group, female smoker)
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