Perceived risks and benefits of smoking: Differences among adolescents with different smoking experiences and intentions

Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco, CA 94118, USA.
Preventive Medicine (Impact Factor: 3.09). 10/2004; 39(3):559-67. DOI: 10.1016/j.ypmed.2004.02.017
Source: PubMed


Explanations of adolescent smoking often make reference to adolescents' beliefs that they are invulnerable to harm. However, empirical examination of whether adolescents do acknowledge risks. Further, few studies have considered perceived benefits in adolescents' behavioral decisions. This study examined perceived smoking-related physical and social risks and benefits between adolescents who have vs. have not smoked and do vs. do not intend to smoke.
Three hundred and ninety-five students (mean age = 14.0) completed a survey concerning their smoking experiences, intentions, and perceived risks and benefits of smoking.
Adolescent smokers and those who intend to smoke estimated their chance of experiencing a smoking-related negative outcome as less likely than did nonsmokers and non-intenders. Smokers and intenders also reported the chance of addiction as less likely than did others. In contrast, adolescent smokers and intenders perceived the chance of experiencing a smoking-related benefit as more likely than did nonsmokers and non-intenders.
The data suggest that rather than solely focusing on health risks as a way to deter adolescent smoking, the role of perceived social risks and benefits in adolescents' smoking may be an additional critical focus for intervention. In addition, efforts should be made to increase adolescents' awareness of the addictive nature of cigarettes.

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    • "" Stage of change was categorized as pre-contemplation (not thinking of quitting in the next 6 months), contemplation (thinking of quitting in the next 6 months), and preparation (thinking of quitting within the next 30 days) (DiClemente, Prochaska, Fairhurst, & Velicer, 1991). Perceived health risks were assessed by adapting work done with adolescents (Halpern-Felsher, Biehl, Kropp, & Rubinstein, 2004). The item was: " Given your current smoking or non-smoking status (that is, the amount you currently smoke), what is the chance (from 0 – 100%) that you will get lung cancer? "
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    ABSTRACT: This study implemented a smoking cessation Readiness Group (RG) in two women-focused residential substance abuse treatment programs, with the aim of engaging women in smoking cessation services. The primary outcome was defined as attending at least one cessation group after the RG ended. The RG combined features of the Expert Systems (ES) approach with a practice quit attempt. ES is an interactive system which tailors intervention to the smokers’ stage of change, while the practice quit attempt rehearses the process of quitting smoking. As a secondary aim we tested whether incentives, used to promote participation and engagement in the RG, would increase initiation of smoking cessation services. Participants (N = 75) were women smokers enrolled in two residential programs, and intention to quit smoking was not required for participation. Twelve participant cohorts were randomly assigned to receive the RG with or without incentives. Following the RG intervention, 38.7% of participants (n = 29) attended at least one smoking cessation session. Both the number of RG sessions attended and a successful practice quit attempt predicted the later use of cessation services, while incentives did not. From pre to post RG, participants reported decreased cigarettes per day (CPD: 11.8 v. 7.6, p < .0001) and decreased nicotine dependence as measured by the Heaviness Smoking Index (HSI: 2.3 v. 1.8, p < .001). The 3-session group-format RG intervention was associated with initiation of smoking cessation services and with changes in smoking behavior.
    No preview · Article · Dec 2015 · Journal of substance abuse treatment
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    • "One factor consistently found to be associated with cigarette use was perceived risk of smoking, which is a well-established correlate [43, 45]. Social norms regarding smoking and perceived risk of smoking have previously been found to be associated [43, 45]. Given the high prevalence of cigarette smoking nationwide in Georgia, these findings are not surprising. "
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    ABSTRACT: Georgia has high smoking rates; however, little is known about the prevalence and correlates of youth smoking. We conducted a secondary data analysis of a 2010 cross-sectional survey of 1,879 secondary and postsecondary school students aged 15 to 24 years in Tbilisi, Georgia, examining substance use, perceived risk, and recreational activities in relation to lifetime and current (past 30 days) smoking. Lifetime and current smoking prevalence was 46.1% and 22.6%, respectively. In secondary schools, lifetime smoking correlates included being male, consuming alcohol, lifetime marijuana use, and lower perceived risk (P's ≤ .001). Correlates of current smoking among lifetime smokers included being male, consuming alcohol, lifetime marijuana use, lower perceived risk, less frequently exercise, and more often going out (P's < .05). In postsecondary schools, lifetime smoking correlates included being male, consuming alcohol, lifetime marijuana use, lower perceived risk, more often going out, and recreational internet use (P's < .0). Correlates of current smoking among lifetime smokers included being male (P's = .04), consuming alcohol, marijuana use, lower perceived risk, and more often going out (P's < .05). Tobacco control interventions might target these correlates to reduce smoking prevalence in Georgian youth.
    Full-text · Article · Mar 2014
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    • "In physical risk I, the OR of susceptibility to smoking decreased with increased quartiles, and overall OR was not statistically significant. These results are consistent with a US study that argued that adolescents generally know the health consequences of smoking but are less aware of its addictive nature [22]. In other words, adolescents might be less concerned about health consequences because they believe that they can quit smoking easily and at any time [22]. "
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    ABSTRACT: Background The perceived risks and benefits of smoking may play an important role in determining adolescents’ susceptibility to initiating smoking. Our study examined the perceived risks and benefits of smoking among adolescents who demonstrated susceptibility or non susceptibility to smoking initiation. Methods In October–November 2011, we conducted a population-based cross-sectional study in Jhaukhel and Duwakot Villages in Nepal. Located in the mid-hills of Bhaktapur District, 13 kilometers east of Kathmandu, Jhaukhel and Duwakot represent the prototypical urbanizing villages that surround Nepal’s major urban centers, where young people have easy access to tobacco products and are influenced by advertising. Jhaukhel and Duwakot had a total population of 13,669, of which 15% were smokers. Trained enumerators used a semi-structured questionnaire to interview 352 randomly selected 14- to 16-year-old adolescents. The enumerators asked the adolescents to estimate their likelihood (0%–100%) of experiencing various smoking-related risks and benefits in a hypothetical scenario. Results Principal component analysis extracted four perceived risk and benefit components, excluding addiction risk: (i) physical risk I (lung cancer, heart disease, wrinkles, bad colds); (ii) physical risk II (bad cough, bad breath, trouble breathing); (iii) social risk (getting into trouble, smelling like an ashtray); and (iv) social benefit (looking cool, feeling relaxed, becoming popular, and feeling grown-up). The adjusted odds ratio of susceptibility increased 1.20-fold with each increased quartile in perception of physical Risk I. Susceptibility to smoking was 0.27- and 0.90-fold less among adolescents who provided the highest estimates of physical Risk II and social risk, respectively. Similarly, susceptibility was 2.16-fold greater among adolescents who provided the highest estimates of addiction risk. Physical risk I, addiction risk, and social benefits of cigarette smoking related positively, and physical risk II and social risk related negatively, with susceptibility to smoking. Conclusion To discourage or prevent adolescents from initiating smoking, future intervention programs should focus on communicating not only the health risks but also the social and addiction risks as well as counteract the social benefits of smoking.
    Full-text · Article · Mar 2013 · BMC Public Health
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