Measuring Cigarette Smoking Risk Perceptions

Annette R Kaufman¹, Jenny E Twesten², Jerry Suls¹, Kevin D McCaul³, Jamie S Ostroff⁴, Rebecca A Ferrer¹, Noel T Brewer^{5

6}, Linda D Cameron⁷, Bonnie Halpern-Felsher⁸, Jennifer L Hay⁴, Elyse R Park^{9

10}, Ellen Peters¹¹, David R Strong^{12

13}, Erika A Waters¹⁴, Neil D Weinstein¹⁵, Paul D Windschitl¹⁶, William M P Klein¹

Affiliations

¹ Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD.
² The Bizzell Group, LLC, Lanham, MD.
³ Department of Psychology, North Dakota State University, Fargo, ND.
⁴ Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY.
⁵ Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
⁶ Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
⁷ School of Social Sciences, Humanities, and the Arts, University of California, Merced, Merced, CA.
⁸ Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA.
⁹ Department of Psychiatry and Medicine, Massachusetts General Hospital, Boston, MA.
¹⁰ Harvard Medical School, Boston, MA.
¹¹ School of Journalism and Communication, University of Oregon, Eugene, OR.
¹² Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA.
¹³ Cancer Prevention and Control Program, Moores Cancer Center, University of California, San Diego, San Diego, CA.
¹⁴ Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, Saint Louis, MO.
¹⁵ Department of Human Ecology, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ.
¹⁶ Department of Psychological and Brain Sciences, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA.

PMID: 31883013
PMCID: PMC7755137
DOI: 10.1093/ntr/ntz213

Review

Measuring Cigarette Smoking Risk Perceptions

Annette R Kaufman et al. Nicotine Tob Res. 2020.

. 2020 Oct 29;22(11):1937-1945.

doi: 10.1093/ntr/ntz213.

Authors

Affiliations

¹ Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD.
² The Bizzell Group, LLC, Lanham, MD.
³ Department of Psychology, North Dakota State University, Fargo, ND.
⁴ Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY.
⁵ Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
⁶ Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
⁷ School of Social Sciences, Humanities, and the Arts, University of California, Merced, Merced, CA.
⁸ Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA.
⁹ Department of Psychiatry and Medicine, Massachusetts General Hospital, Boston, MA.
¹⁰ Harvard Medical School, Boston, MA.
¹¹ School of Journalism and Communication, University of Oregon, Eugene, OR.
¹² Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA.
¹³ Cancer Prevention and Control Program, Moores Cancer Center, University of California, San Diego, San Diego, CA.
¹⁴ Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, Saint Louis, MO.
¹⁵ Department of Human Ecology, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ.
¹⁶ Department of Psychological and Brain Sciences, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA.

PMID: 31883013
PMCID: PMC7755137
DOI: 10.1093/ntr/ntz213

Abstract

Risk perception is an important construct in many health behavior theories. Smoking risk perceptions are thoughts and feelings about the harms associated with cigarette smoking. Wide variation in the terminology, definition, and assessment of this construct makes it difficult to draw conclusions about the associations of risk perceptions with smoking behaviors. To understand optimal methods of assessing adults' cigarette smoking risk perceptions (among both smokers and nonsmokers), we reviewed best practices from the tobacco control literature, and where gaps were identified, we looked more broadly to the research on risk perceptions in other health domains. Based on this review, we suggest assessments of risk perceptions (1) about multiple smoking-related health harms, (2) about harms over a specific timeframe, and (3) for the person affected by the harm. For the measurement of perceived likelihood in particular (ie, the perceived chance of harm from smoking based largely on deliberative thought), we suggest including (4) unconditional and conditional items (stipulating smoking behavior) and (5) absolute and comparative items and including (6) comparisons to specific populations through (7) direct and indirect assessments. We also suggest including (8) experiential (ostensibly automatic, somatic perceptions of vulnerability to a harm) and affective (emotional reactions to a potential harm) risk perception items. We also offer suggestions for (9) response options and (10) the assessment of risk perception at multiple time points. Researchers can use this resource to inform the selection, use, and future development of smoking risk perception measures.

Implications: Incorporating the measurement suggestions for cigarette smoking risk perceptions that are presented will help researchers select items most appropriate for their research questions and will contribute to greater consistency in the assessment of smoking risk perceptions among adults.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.

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Figures

**Figure 1.**
Example survey items for assessing adult cigarette smokers’ risk perceptions of lung cancer.

See this image and copyright information in PMC

References

1. National Cancer Institute. The Economics of Tobacco and Tobacco Control. NCI Tobacco Control Monograph Series 21. NIH Publication No. 16-CA-8029A. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute; / Geneva, Switzerland: World Health Organziation; 2016.
1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014:17.
1. United Nations Development Programme. Human Development Index. New York: United Nations Development Programme; 2018. http://hdr.undp.org/en/content/human-development-index-hdi. Accessed October 16, 2019
1. Drope J, Schluger NW, Cahn Z, et al. Prevalence. In: Drope J, Schluger NW, eds. The Tobacco Atlas. 6th ed Atlanta, GA: American Cancer Society and Vital Strategies; 2018:20–21.
1. Weinstein ND, Marcus SE, Moser RP. Smokers’ unrealistic optimism about their risk. Tob Control. 2005;14(1):55–59. - PMC - PubMed

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Measuring Cigarette Smoking Risk Perceptions

Affiliations

Measuring Cigarette Smoking Risk Perceptions

Authors

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Abstract

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