By Sude Kulak, HMP Governance Lab Fellow
Tobacco and nicotine use are associated with chronic health conditions and health risks, making it important to understand how people perceive the potential harms of products. As the tobacco and nicotine landscape continues to change, newer products such as nicotine pouches, e-cigarettes, and heated tobacco products have also emerged. These products differ in how they deliver nicotine and are used. Although these products may be marketed as a lower risk alternative, there are no safe tobacco products and all pose health risks and contribute to nicotine addiction.
As part of our research team's ongoing scoping review, we are examining existing literature on the sources and drivers of tobacco and nicotine risk perceptions among adults aged 55 and older in the United States. During our preliminary literature-screening process, we have noticed that much of the available research emphasizes younger populations. Although these are early observations that require further examination, they raise questions about how much is currently known about older adults’ tobacco and nicotine risk perceptions.
Older adults are important to consider not only because of their own health decisions, but also because of their roles as parents, grandparents, caregivers, and trusted members of their communities. Their personal experiences, knowledge, and beliefs about tobacco products may shape how they discuss tobacco-related health risks with younger generations.
Research examining smoking behaviors across generations provides evidence of the importance of these family relationships. For example, Sari et al. (2023) examined smoking behaviors across three generations in Northern Norway and revealed the key role of maternal grandparents in mitigating the risk of smoking among their grandchildren. Their findings highlight the importance of considering grandparents and other older family members when examining tobacco-related behaviors and influences.
Although this study was conducted in Norway rather than the United States, it provides an example of how older family members may influence smoking behaviors across generations. In the United States, it is also important to understand how older adults' tobacco-related knowledge, experiences, and perceptions may shape conversations about tobacco and nicotine use within families. In particular, examining the sources of information older adults rely on and how they understand the risks of different tobacco and nicotine products may provide insight into how these beliefs are developed and shared. This research also focuses on smoking behaviors rather than risk perceptions, but it raises an important question: How might older adults' understanding of tobacco and nicotine-related risks influence the information and beliefs shared within their families? Understanding where older adults obtain tobacco-related information and what shapes their perceptions could provide valuable insight into how these beliefs develop and are communicated across generations.
Moving forward, researchers should make greater efforts to include older adults in tobacco-related studies and report findings separately by age. Additional research should examine the information sources, personal experiences, and individual characteristics that shape older adults' perceptions of different tobacco and nicotine products. This includes understanding how older adults perceive both traditional tobacco products and newer products, such as nicotine pouches, e-cigarettes, and heated tobacco products. Greater attention to family communication could also help clarify how these perceptions are discussed across generations.
