Abstract. Cigarette smoking among college students continues to be a major health concern in the United States. Studies showed that peer influences, weight control behavior, depression, anxiety, and stress are significant predictors of cigarette smoking among college students. With increases in use, there is concern among public health officials as to whether e-cigs represent a ;;gateway;; to future tobacco cigarette smoking and whether e-cigs will lead to nicotine addiction among youth. The other side of this argument supports the concept of e-cigs as a harm reduction product to reduce cigarette smoking, resulting in e-cigs being marketed as ;;safer;; alternatives to cigarette smoking. College students are included in the age group 18-24 shown to be at increased risk for using nontraditional tobacco products, including e-cigs. College students are often drawn to novel products and are generally more accepting of e-cig use in public compared with cigarette smoking. Objective. The purpose of this cross-sectional descriptive study is to better understand the perception of international undergraduate students at UW-La Crosse regarding the harm associated with smoking tobacco. Participants. A total of 22 International Undergraduate students from the University of Wisconsin-La Crosse participated in the study in March of 2017. Participants completed a web-based questionnaire consisting of demographic items as well as items related to perception of harm by smoking tobacco. Methods. Descriptive statistics were used to determine the frequency and percentage. Results. According to the survey e-cigarettes were perceived as having the least amount of risk, followed by hookah and cigars, cigarillos, and then cigarettes. Students who perceived a continuum of cigarette-related harm were consistently more likely to perceive e-cigarettes as less harmful than conventional cigarettes compared to those with a consistently high perception of cigarette harm. Such findings suggest that many students may be susceptible to e-cigarette use. Hookah and electronic cigarettes were the most favorably perceived products, which may reflect the effective efforts to market these products as safe and socially acceptable. E-Cigarettes and Hookah seem to have particularly high appeal among this population, with very high positive perceptions in terms of low perceived harm to health as well as high social acceptability. Furthermore, e-cigarettes and hookah were the most commonly used tobacco products daily and less than monthly. Conclusions. The present study provides information regarding perceptions of harm to health by smoking various tobacco products. E-cigarette was generally perceived to be the least harmful, with cigar;;s and hookah closely following. Cigarettes and cigarillos were perceived as the most negatively and more harmful to health. Future research is needed to document reasons for these perceptions as well as to document the true nature of health risks. Doing so will inform the development of public health campaigns and interventions to alter these perceptions related to the use of these tobacco products.
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Perception of harm in UWL international undergraduates on smoking tobacco