A survey reveals that a significant majority of policy experts continue to wrongly identify nicotine as the primary cause of smoking-related diseases, despite evidence to the contrary. This persistent misinformation has implications for public health policy and harm reduction strategies. The difficulty in correcting ingrained beliefs is a negative factor for effective policy-making. Investors in the tobacco or nicotine alternative industries should be aware of how public perception and policy decisions are influenced by such misunderstandings. Clarity on the science of smoking-related diseases is crucial.