Knowledge and perceived risk of smoking-related conditions: a survey of cigarette smokers
Introduction
Several studies suggest that smokers minimize the personal health risks of cigarette smoking [1]. One recent survey showed that the majority of smokers underestimate their personal risk of two smoking-related conditions (cancer and heart disease) compared with nonsmokers [2]. Additional studies suggest that smokers also underestimate personal health risks of other smoking-related conditions [3].
Perceived risk of a smoking-related illness requires an adequate knowledge of the harmful effects of smoking. Although some studies suggest that smokers know the potential harmful effects of smoking, such as lung cancer [4], [5], studies also suggest that more education is needed to inform patients of the health risks of cigarette smoking including the lesser-known risks [4], [6], [7], [8], [9]. Consequently, smokers may not perceive themselves to be at risk for various smoking-related illnesses because they do not know the harmful effects of tobacco smoking. Additionally, some studies suggest that age, sex, prior history of illness, and education may contribute to perceived risk of tobacco-related illnesses [2], [3].
To date, most studies assess either knowledge or perceived risk, and questions primarily focus on heart and lung disease and not other smoking related risks (e.g., other cancers, infertility), or the potential impact of these illnesses (e.g., premature death or disability). This study examines whether various health risks of cigarette smoking are known and are perceived to be a personal health risk by cigarette smokers. Evaluating knowledge and perceived risk can provide insight into whether more patient education is needed and in what areas, or if clinicians should place more emphasis on personalizing these risks for an individual smoker. Determining whether knowledge and perceived risks of smoking differ by age, gender, socioeconomic status and general health could also be used to inform smoking cessation education and treatment programs.
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Participants and procedure
The sample consisted of 537 treatment-seeking smokers from the Greater New Haven, CT, area entering a clinical smoking cessation trial. Eligibility criteria included being at least 18 years of age, currently smoking at least 10 cigarettes per day, and having a baseline expired carbon monoxide level of at least 10 ppm. Participants were excluded if they were medically unstable as determined by medical history and physical exam, or suffering from a major psychiatric disorder or alcohol dependent
Demographics
The demographics of the study population are listed in Table 1. The sample is predominately white, approximately half are females, and 40% of subjects had graduated from high school. Subjects smoke on average at least a pack per day, and the majority had smoked for greater than 20 years.
Knowledge of smoking-related disease
Overall, scores indicating accurate knowledge of diseases associated with smoking were variable across disease conditions. Pulmonary, cardiovascular, and oral diseases were most likely to be recognized by
Discussion
Our study found that knowledge of smoking-related illnesses is high with regard to some of the well-known risks of smoking (i.e., heart disease and pulmonary disease), but lower for cancers other than lung cancer (i.e., cervical, head and neck, bladder cancer), and for reproductive-related risks of smoking and other diseases (such as osteoporosis and peptic ulcer disease). Although knowledge of premature death was high among smokers, knowledge and perceived risk that smoking causes disability
Acknowledgments
This report was supported in part by NIH grants DA 13334, DA15167, RR06192, CA89053.
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