Perceptions of health risks of cigarette smoking: A new measure reveals widespread misunderstanding

Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps Americans do not accurately perceive the extent to which smoking increases the probability of adverse health outcomes. This paper examines th...

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Vydáno v:	PloS one Ročník 12; číslo 8; s. e0182063
Hlavní autoři:	Krosnick, Jon A., Malhotra, Neil, Mo, Cecilia Hyunjung, Bruera, Eduardo F., Chang, LinChiat, Pasek, Josh, Thomas, Randall K.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 14.08.2017 Public Library of Science (PLoS)
Témata:	Americans Biology and Life Sciences Cigarette smoking Confidence intervals Decision making Drug addiction Health Health aspects Health risk assessment Health risks Humans Lung cancer Lung diseases Lung Neoplasms - etiology Medicine and Health Sciences Perception Perceptions Research and Analysis Methods Risk Risk assessment Risk Factors Risk perception Smoke Smoking Smoking - adverse effects Smoking Cessation Social Sciences Statistical analysis Statistical analysis of data Studies Surveys and Questionnaires United States New York United States > US California
ISSN:	1932-6203, 1932-6203
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Abstract	Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps Americans do not accurately perceive the extent to which smoking increases the probability of adverse health outcomes. This paper examines the accuracy of Americans' perceptions of the absolute risk, attributable risk, and relative risk of lung cancer, and assesses which of these beliefs drive Americans' smoking behavior. Using data from three national surveys, statistical analyses were performed by comparing means, medians, and distributions, and by employing Generalized Additive Models. Perceptions of relative risk were associated as expected with smoking onset and smoking cessation, whereas perceptions of absolute risk and attributable risk were not. Additionally, the relation of relative risk with smoking status was stronger among people who held their risk perceptions with more certainty. Most current smokers, former smokers, and never-smokers considerably underestimated the relative risk of smoking. If, as this paper suggests, people naturally think about the health consequences of smoking in terms of relative risk, smoking rates might be reduced if public understanding of the relative risks of smoking were more accurate and people held those beliefs with more confidence.
AbstractList	Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps Americans do not accurately perceive the extent to which smoking increases the probability of adverse health outcomes. This paper examines the accuracy of Americans' perceptions of the absolute risk, attributable risk, and relative risk of lung cancer, and assesses which of these beliefs drive Americans' smoking behavior. Using data from three national surveys, statistical analyses were performed by comparing means, medians, and distributions, and by employing Generalized Additive Models. Perceptions of relative risk were associated as expected with smoking onset and smoking cessation, whereas perceptions of absolute risk and attributable risk were not. Additionally, the relation of relative risk with smoking status was stronger among people who held their risk perceptions with more certainty. Most current smokers, former smokers, and never-smokers considerably underestimated the relative risk of smoking. If, as this paper suggests, people naturally think about the health consequences of smoking in terms of relative risk, smoking rates might be reduced if public understanding of the relative risks of smoking were more accurate and people held those beliefs with more confidence. Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps Americans do not accurately perceive the extent to which smoking increases the probability of adverse health outcomes. This paper examines the accuracy of Americans' perceptions of the absolute risk, attributable risk, and relative risk of lung cancer, and assesses which of these beliefs drive Americans' smoking behavior. Using data from three national surveys, statistical analyses were performed by comparing means, medians, and distributions, and by employing Generalized Additive Models. Perceptions of relative risk were associated as expected with smoking onset and smoking cessation, whereas perceptions of absolute risk and attributable risk were not. Additionally, the relation of relative risk with smoking status was stronger among people who held their risk perceptions with more certainty. Most current smokers, former smokers, and never-smokers considerably underestimated the relative risk of smoking. If, as this paper suggests, people naturally think about the health consequences of smoking in terms of relative risk, smoking rates might be reduced if public understanding of the relative risks of smoking were more accurate and people held those beliefs with more confidence.Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps Americans do not accurately perceive the extent to which smoking increases the probability of adverse health outcomes. This paper examines the accuracy of Americans' perceptions of the absolute risk, attributable risk, and relative risk of lung cancer, and assesses which of these beliefs drive Americans' smoking behavior. Using data from three national surveys, statistical analyses were performed by comparing means, medians, and distributions, and by employing Generalized Additive Models. Perceptions of relative risk were associated as expected with smoking onset and smoking cessation, whereas perceptions of absolute risk and attributable risk were not. Additionally, the relation of relative risk with smoking status was stronger among people who held their risk perceptions with more certainty. Most current smokers, former smokers, and never-smokers considerably underestimated the relative risk of smoking. If, as this paper suggests, people naturally think about the health consequences of smoking in terms of relative risk, smoking rates might be reduced if public understanding of the relative risks of smoking were more accurate and people held those beliefs with more confidence.
Audience	Academic
Author	Pasek, Josh Thomas, Randall K. Mo, Cecilia Hyunjung Bruera, Eduardo F. Krosnick, Jon A. Malhotra, Neil Chang, LinChiat
AuthorAffiliation	4 Hoover Institution, Stanford University, Stanford, California, United States of America 7 Department of Communication Studies, University of Michigan, Ann Arbor, Michigan, United States of America 8 GfK Custom Research North America, New York City, New York, United States of America 6 LinChiat Chang Consulting, LLC, San Francisco, California, United States of America 1 Department of Communication, Stanford University, Stanford, California, United States of America 5 U.S. Department of Treasury, Washington, D.C., United States of America Legacy, Schroeder Institute for Tobacco Research and Policy Studies, UNITED STATES 3 Department of Political Science, Vanderbilt University, Nashville, Tennessee, United States of America 2 Graduate School of Business, Stanford University, Stanford, California, United States of America
AuthorAffiliation_xml	– name: 3 Department of Political Science, Vanderbilt University, Nashville, Tennessee, United States of America – name: 6 LinChiat Chang Consulting, LLC, San Francisco, California, United States of America – name: 7 Department of Communication Studies, University of Michigan, Ann Arbor, Michigan, United States of America – name: 2 Graduate School of Business, Stanford University, Stanford, California, United States of America – name: 4 Hoover Institution, Stanford University, Stanford, California, United States of America – name: 8 GfK Custom Research North America, New York City, New York, United States of America – name: 1 Department of Communication, Stanford University, Stanford, California, United States of America – name: Legacy, Schroeder Institute for Tobacco Research and Policy Studies, UNITED STATES – name: 5 U.S. Department of Treasury, Washington, D.C., United States of America
Author_xml	– sequence: 1 givenname: Jon A. surname: Krosnick fullname: Krosnick, Jon A. – sequence: 2 givenname: Neil surname: Malhotra fullname: Malhotra, Neil – sequence: 3 givenname: Cecilia Hyunjung orcidid: 0000-0001-5974-2525 surname: Mo fullname: Mo, Cecilia Hyunjung – sequence: 4 givenname: Eduardo F. surname: Bruera fullname: Bruera, Eduardo F. – sequence: 5 givenname: LinChiat surname: Chang fullname: Chang, LinChiat – sequence: 6 givenname: Josh surname: Pasek fullname: Pasek, Josh – sequence: 7 givenname: Randall K. surname: Thomas fullname: Thomas, Randall K.
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/28806420$$D View this record in MEDLINE/PubMed
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: LC and RKT have commercial affiliations with LinChiat Chang Consulting and GfK Custom Research North America, respectively. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Conceptualization: JAK LC.Data curation: JAK NM CHM LC JP RKT.Formal analysis: NM CHM LC JP.Funding acquisition: JAK RKT.Investigation: JAK LC RKT.Methodology: NM LC JP.Project administration: JAK NM CHM.Resources: JAK RKT.Software: NM CHM LC JP RKT.Supervision: JAK.Validation: NM CHM JP.Visualization: NM CHM LC JP.Writing – original draft: JAK NM CHM EFB JP.Writing – review & editing: JAK NM CHM EFB JP.
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Snippet	Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps...
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SubjectTerms	Americans Biology and Life Sciences Cigarette smoking Confidence intervals Decision making Drug addiction Health Health aspects Health risk assessment Health risks Humans Lung cancer Lung diseases Lung Neoplasms - etiology Medicine and Health Sciences Perception Perceptions Research and Analysis Methods Risk Risk assessment Risk Factors Risk perception Smoke Smoking Smoking - adverse effects Smoking Cessation Social Sciences Statistical analysis Statistical analysis of data Studies Surveys and Questionnaires
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Title	Perceptions of health risks of cigarette smoking: A new measure reveals widespread misunderstanding
URI	https://www.ncbi.nlm.nih.gov/pubmed/28806420 https://www.proquest.com/docview/1928765510 https://www.proquest.com/docview/1929105778 https://pubmed.ncbi.nlm.nih.gov/PMC5555635 https://doaj.org/article/5622d0ee97844f48ae48ac6bab110608 http://dx.doi.org/10.1371/journal.pone.0182063
Volume	12
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