While FDA and its Center for Tobacco Products are beginning to acknowledge Americans badly misunderstand the relative risks of nicotine vaping products compared with cigarettes, recent research out of UT Southwestern Medical Center identifies FDA’s own Real Cost campaign “An Epidemic Is Spreading” as a significant contributor to that collapse in public understanding.
The U.S. study found that 30% of adults surveyed now believe nicotine vapes are more harmful than cigarettes, a more than tenfold increase, while the proportion who correctly recognized vaping as less harmful than smoking collapsed from half of U.S. adults to just 17%.
In this episode of RegWatch, study author Dr. Alexander Wu and lung cancer specialist Dr. David Gerber examine the dramatic reversal in public perception and the consequences for adult smokers.
Researchers found statistically significant shifts associated with FDA’s Real Cost campaign and the 2019 EVALI outbreak. Following these major events, more Americans became afraid of vaping and less afraid of smoking.
The same disturbing trend appeared across age, sex, race, ethnicity, and smoking status. And while FDA’s campaign was aimed at youth, the study documented the deterioration in public understanding among American adults.
Gerber says it may now be time for health professionals and public health communities to intervene and correct these dangerous misperceptions.
Did FDA help create the public health crisis it now says must be fixed?
Find out. Only on RegWatch by RegulatorWatch.com.
Released: October 17, 2026
Produced by: Brent Stafford
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