Smokers' unrealistic optimism about their risk.
OBJECTIVE
Past studies have produced ambiguous or inconsistent results when testing whether smokers actually underestimate their own risks of experiencing tobacco related illness. Whereas smokers claim that they are less at risk than the average smoker on self administered questionnaires, this unrealistic optimism has not been found in telephone or face-to-face interviews. We avoided the measurement problems of past studies and examined responses to a number of new questions to assess different aspects of smokers' perceptions.


METHODS
A US national telephone survey (n = 6369; 1245 current smokers) posed a variety of questions designed to examine beliefs about the risks of smoking. For key questions, separate samples of smokers were asked either about their own risk or about the risk of the average smoker.


RESULTS
Smokers underestimated their relative risk compared to non-smokers and, contrary to previous interview surveys, believed they have a lower risk of developing lung cancer than the average smoker. Furthermore, their perceived risk of lung cancer and of cancer in general barely increases with the number of cigarettes smoked per day, and their estimates of their risk of cancer are actually slightly lower than their estimates of their risk of lung cancer. Substantial proportions of smokers and former smokers agree with several myths, more than half agreeing that exercise undoes most smoking effects.


CONCLUSIONS
Smokers underestimate their risk of lung cancer both relative to other smokers and to non-smokers and demonstrate other misunderstandings of smoking risks. Smoking cannot be interpreted as a choice made in the presence of full information about the potential harm.
Weinstein
N D
ND
Department of Human Ecology, Rutgers University, Cook Office Building, 55 Dudley Road, New Brunswick, NJ 08901-8520, USA. neilw@aesop.rutgers.edu
Marcus
S E
SE
Moser
R P
RP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003469:Culture; D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology
Science. 1998 May 8;280(5365):867-73
9572724
J Health Commun. 2004 Sep-Oct;9(5):443-60; discussion 81-4
15513791
Br J Psychol. 1993 Aug;84 ( Pt 3):389-94
8401990
Health Psychol. 1988;7(6):575-89
3215163
Health Psychol. 1995 May;14(3):217-22
7641662
JAMA. 1999 Mar 17;281(11):1019-21
10086437
J Behav Med. 1987 Oct;10(5):481-500
3430590
Nicotine Tob Res. 2004 Dec;6 Suppl 3:S375-80
15799601
J Behav Med. 1995 Feb;18(1):45-54
7595951
Organ Behav Hum Decis Process. 2000 Jan;81(1):115-131
10631071
Prev Med. 1986 Jul;15(4):363-72
3763561
Nicotine Tob Res. 2004 Feb;6(1):1-6
14982682
Nicotine Tob Res. 1999;1 Suppl 1:S123-30
11184311
J Behav Med. 1992 Oct;15(5):469-88
1447758
J Natl Cancer Inst. 1995 May 17;87(10):720-31
7563149
Med Decis Making. 2001 Jan-Feb;21(1):37-44
11206945