Information, risk perception, and the role of e-cigarettes according to a recent national survey

In recent years, e-cigarettes have firmly entered the landscape of alternative products to traditional smoking. Despite their spread, the level of knowledge among citizens remains heterogeneous and often fragmented: many people still tend to consider e-cigs, heated tobacco products, and other devices as a single undifferentiated category of “electronic smoking.”

A recent national survey conducted by Euromedia Research for ANAFE captured the perceptions, habits, and knowledge of Italians regarding e-cigarettes. The picture that emerges is complex: on one hand, a portion of the adult population that consistently uses e-cigs for specific purposes; on the other, a broad majority that declares itself poorly informed and expresses doubts about the risk profile of these products compared to combustible cigarettes.

In this article, we analyze the main findings of the survey, with an informative and neutral approach, to contribute to a more structured reading of the phenomenon and to the debate on sector regulation.

Level of information: only 1 in 3 Italians feels up to date

According to the Euromedia survey, about one-third of the Italian population declares feeling “very” or “fairly” informed about alternative smoking products, which include e-cigarettes, inhalation liquids, and heated tobacco devices. The proportion of people who consider themselves poorly or not at all informed exceeds 60%, peaking among non-smokers and older age groups.

These data suggest that the topic is perceived as relevant but not always accompanied by clear and up-to-date information. In many cases, opinions are formed through word of mouth, mainstream media, or social networks, with the risk of overlapping different product categories or attributing characteristics to e-cigs that belong to other devices.

Young people more informed, but not necessarily more aware

The research highlights greater familiarity with the topic among young adults (18–44 years), who report higher levels of information compared to the over-45 age groups. This does not mean, however, that their knowledge is always in-depth: even in these groups, doubts remain about the technical differences between e-cigarettes, heated tobacco products, and other nicotine solutions.

Risk perception: between equivalence and uncertainty

One of the most significant findings concerns the perception of harmfulness. Nearly one in two Italians believes that e-cigarettes are “equally harmful” compared to traditional ones, while about a third considers them only “slightly less harmful.” Only a minority judges them “much less harmful,” confirming widespread uncertainty about their risk profile.

In parallel, the majority of the sample declares itself in favor of equating e-cigs and combustible cigarettes in terms of bans, regulations, and taxation. This finding reflects the tendency, at the level of public perception, to consider the different product categories as substantially similar.

The role of misinformation

The research highlights a direct link between the level of information and risk perception: those who claim to know the sector better tend more often to recognize differentiated characteristics between products; those who feel less informed tend instead to consider them all equally dangerous.

This aspect highlights the need for clearer and more structured institutional communication that helps citizens, operators, and decision makers distinguish between the various types of products, their respective technical standards, and evolving regulatory scenarios at the European level (for example within the Tobacco Products Directive – TPD).

Who uses e-cigarettes in Italy today

The survey estimates that 5.1% of the Italian adult population uses e-cigarettes exclusively. Within this segment, over nine out of ten users declare having been traditional smokers in the past, confirming that e-cigs are predominantly adopted by people who already have a history of combustible tobacco use.

Among the main motivations reported by users:
• the desire to reduce the risks associated with smoking;
• the attempt to undertake a cessation path;
• the search for a lesser olfactory impact compared to traditional cigarettes;
• the curiosity toward a technology perceived as innovative.

Data and interpretations: a public policy issue

It is important to emphasize that these elements derive from respondents' statements and fall within the framework of risk reduction policies discussed at the international level. Their interpretation requires caution and constant comparison with independent scientific evidence and with the assessments of national and European health authorities.

Trend, alternative, or harm reduction tool?

When Italians are asked what e-cigarettes represent today, the general sample tends to frame them mainly as:
• a “new trend” that is spreading (about a third of respondents);
• a “cigarette surrogate” (about a quarter).

Only a minority identifies them as:
• a possible tool to limit the risks associated with smoking,
• additional support in a cessation path.

This reading, however, changes radically when looking at actual e-cigarette users, who tend to place the product in a more functional perspective: a regulated alternative, part of an attempt to quit traditional smoking, a tool that fits within the harm reduction strategies discussed in the sector.

Satisfaction and continuity of use among adult vapers

Among those who use e-cigarettes, the level of satisfaction is generally high: over 80% of respondents declare themselves “very” or “fairly” satisfied, and more than nine out of ten users state that, given the chance to go back, they would make the same choice to start using e-cigs.

These data describe a pool of adult users who experience e-cigarettes as an established solution, often part of a change in habits that began with the transition from traditional smoking. In this case too, interpretations on the health and regulatory level remain the responsibility of competent authorities and the scientific community.

The regulatory framework: between TPD, bans, and responsibilities

In Europe, e-cigarettes are primarily regulated within the Tobacco Products Directive (TPD), transposed in Italy through national legislation. The regulatory framework defines, among other aspects:
• labeling and packaging requirements;
• nicotine concentration limits in inhalation liquids;
• product notification obligations to competent authorities;
• regulations on sales bans to minors and commercial communications.

For manufacturers and authorized distributors, compliance with these rules is a central element of industrial responsibility and adult consumer protection. For citizens, knowing the main regulatory coordinates can help distinguish between authorized channels and non-compliant offers, especially in a context where the digital market makes products from countries with different rules easily accessible.

Why correct information is a key factor

The Euromedia survey clearly shows that direct experience with e-cigarettes and the level of information significantly influence risk perception. Where knowledge is higher, the ability to distinguish between product categories, authorized channels, and regulatory frameworks increases; where information is scarce, the idea that “everything is the same” prevails and that alternative products to traditional smoking show no relevant differences.

For this reason, in the vaping sector:
• informational education aimed solely at adult consumers and professional operators is crucial;
• regulatory clarity and consistency of rules help prevent distorted interpretations;
• a neutral and non-promotional language, based on verifiable data, is essential for a responsible discussion.

Conclusions

The picture that emerges from the research is that of an Italy divided between interest, curiosity, and misinformation. On one hand, a minority of adult users who know e-cigarettes up close and tend to interpret them in terms of changing their habits; on the other, a majority of citizens who continue to perceive them as products substantially comparable to traditional cigarettes, often without a clear distinction between the different available technologies.

In a regulated and constantly evolving sector, the main challenge remains providing correct, up-to-date, and accessible information, in line with current legislation and the guidelines of competent authorities. Only in this way is it possible to promote informed choices by adult consumers and a public debate based on data, not on distorted perceptions or partial narratives.