title: Smokers' unrealistic optimism about their risk.
abstract: 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.
authors.affiliation: Department of Human Ecology, Rutgers University, Cook Office Building, 55 Dudley Road, New Brunswick, NJ 08901-8520, USA. neilw@aesop.rutgers.edu
authors.forename: N D
authors.initials: ND
authors.lastname: Weinstein
authors.forename: S E
authors.initials: SE
authors.lastname: Marcus
authors.forename: R P
authors.initials: RP
authors.lastname: Moser
mesh_terms: 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
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