Elsevier

Preventive Medicine

Volume 15, Issue 4, July 1986, Pages 363-372
Preventive Medicine

General article
Perceived personal immunity: The development of beliefs about susceptibility to the consequences of smoking

https://doi.org/10.1016/0091-7435(86)90004-6Get rights and content

Abstract

Students ages 10 to 18 were given the task of estimating the probability of four possible consequences of cigarette smoking: heart trouble, cancer, carbon monoxide in alveolar air, and breathlessness during strenuous exercise. Subjects made estimates for generalized others who smoke, for themselves as hypothetical lifelong smokers, and for their actual selves. Comparisons of generalized others with hypothetical self and of hypothetical self with actual self suggest that subjects engage in significant denial. Smokers denied their susceptibility more than nonsmokers for generalized others and for themselves as hypothetical lifelong smokers. Compared with nonsmokers, smokers admitted an increased likelihood of experiencing the consequences of smoking when they predicted for their actual self, suggesting some objective awareness of their increased risk status. Smokers saw themselves as highly susceptible to carbon monoxide and breathlessness. This lends support to the current focus on instruction about immediate consequences of smoking as being potentially efficacious in deterring smoking in youth.

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    These higher impact regulatory studies included research demonstrating that reducing nicotine content in cigarettes to minimally addictive levels can reduce the addiction potential of smoking in vulnerable populations and across a wide range of nicotine dependence severity levels (Higgins et al., 2018). Also included among this work are innovative studies on risk perception including a seminal study (Hansen and Malotte, 1986) characterizing what is now a well-established bias in smoking risk perception wherein people rate smoking-related risks to themselves as being less than the risks of smoking they assign to others. These early studies establishing biases in smoking-related risk perception were followed by a series of studies demonstrating the importance of integrating knowledge on human biases in risk perceptions for understanding dual use (Pepper et al., 2017) and developing effective message framing to reduce smoking (Noar et al., 2018; Hall et al., 2020).

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    Among other reasons, many smokers probably agree that smoking is harmful in general, but they endorse a number of self-exempting beliefs that help them to dissipate the cognitive dissonance existing between such general agreement and their smoking habit (Festinger, 1957). Several empirical studies have investigated this topic in Australia, United Kingdom, United States, and Canada (Chapman & Rubinstein, 1987; Chapman, Wong, & Smith, 1993; Hansen & Malotte, 1986). As such risk denial prevents many smokers from quitting, a better understanding of the rationalizations that sustain it would help prevention campaigns to target priority self-exempting beliefs (Oakes, Chapman, Borland, Balmford, & Trotter, 2004; Yong, Borland, & Siahpush, 2005).

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Supported by California Department of Health Services Contract 82-79828 and National Institute on Drug Abuse Grant 1-R01-DA-02941.

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