Public perception of health risks posed by smoking may be declining, study says

About 3 out of 4 Americans agree that smoking cigarettes causes health problems, but public perception of the risks posed by smoking may be declining, according to a Duke Health study published in the journal Drug and Alcohol Dependence.

From 2006 to 2015, the number of Americans who said smoking a pack or more per day posed a great health risk dropped by 1 percent, which represents more than 3 million Americans.

So far, the change in perceived risk has not appeared to result in more smokers. During the same period, smokers in the U.S. dropped from 20.8 percent to 15.1 percent, according to statistics from the Centers for Disease Control and Prevention. But it could signal a potential slowing of progress.

"That's 3 million people who might be more likely to start smoking, go back to smoking, or who are less likely to quit if they already smoke," said Lauren Pacek, Ph.D., the study's lead author and an assistant professor in psychiatry and behavioral sciences at Duke. The change in risk perception also changed more significantly in women than in men, the authors found.

"We were surprised by the findings," said co-author Joe McClernon, Ph.D., professor in psychiatry and behavioral sciences. "Cigarettes haven't fundamentally changed over the last 15 years. They're no safer. And we continue to see that large numbers of Americans are dying from tobacco related disease -- as many as 400,000 a year. So, it's curious that the facts haven't changed, but the risk perceptions have gone down."

The findings are based on responses from more than 559,000 people over age 12 who took the National Survey on Drug Use and Health, an in-home survey administered by the Substance Abuse and Mental Health Services Administration since the 1970s.

The survey asks: "How much do people risk harming themselves physically and in other ways when they smoke one or more packs of cigarettes per day?" Respondents selected "no risk," "slight risk," "moderate risk," or "great risk."

As the number of respondents who saw smoking as a great risk declined, the number of who said it posed no risk increased, jumping from 1.45 percent to 2.63 percent over the 10-year span.

Older teens and adults were more likely than teens 12 to 17 to see smoking as a great health risk. Daily smokers were less likely than former smokers and non-smokers to see cigarette use dangerous to their health.

A number of factors could be driving the change, McClernon said, including message fatigue.

"The idea here is that Americans have heard so often, and for so long, about how harmful cigarettes are that the message is less impactful," McClernon said. It may also be possible that fewer Americans know smokers or people with tobacco-related disease, and this also could decrease perceived harm, he said.

"We'd like to see public policy experts and population health advocates look at these findings, step back and work on ways to increase public perception of the cigarette smoking risks," McClernon said. "Maybe that's through public education campaigns or changes in tobacco product labeling. We think our data suggest that there are some segments of the population -- women and young teens, for instance -- who might benefit more from these efforts."

The Duke researchers are conducting several ongoing projects to examine how different tobacco products, such as electronic cigarettes, influence people's perception of smoking risks or the decision to quit.


  1. Scott Ewing Scott Ewing United States says:

    They young people that I work with mostly vape if anything, but they know that we're in a 'reefer madness' phase, when it comes to smoking. Tough luck haters.

  2. Chris Sorochin Chris Sorochin United States says:

    It seems to me that if you want people to listen, stick to the known facts: some studies show a correlation between smoking and the likelihood of contracting certain diseases.  Lose the hysteria about how smoking "kills millions of people every week" and "kills everyone within a fifty-mile radius", etc.
    Oh, and stop trying to turn smokers into social pariahs.  This just makes you look like bullies.

  3. Kin Free Kin Free United Kingdom says:

    Good to see some small confirmation, in this propaganda evaluation report, of what has been suspected for quite some time - that the anti-smoker campaign is failing despite $billions being spent to maintain it.

    There has been a recent ominous increase in anti-smoker propaganda - always a good indicator of a failure to maintain the planned 'perceptions'. Noticeable too is an increased urgency in fast-forwarding anti-smoker planned coercive ordinances. This suggest that there are fears, within the anti-smoker prohibition industry, that the whole shebang is about to collapse. Let's hope this happens sooner rather than later so less damage and injury is caused by them.

    Some parts of your report need clarification: In the First line we see that "About 3 out of 4 Americans agree (ergo 1 in 4 Americans DO NOT agree) that smoking cigarettes causes health problems"  but later; "the number of who said it posed no risk increased, jumping from 1.45 percent to 2.63 percent over the 10-year span." So is it 25% or 2.63% or is 2.63% an increase over the 1 in 4 who don't agree with the propaganda? I'm sure there will be a simple explanation, but it isn't clear here.

    Given the evidence that is coming to light that supports the position that smoking could actually be BENEFICIAL to health and cognitive ability, one ominous but unsurprising omission is any question of how many people agree with this. The question, for anti-smoker propagandists of course, is never whether smoking may be beneficial or not but to maintain the illusion that smoking is bad - any discussion should always be limited as to just how bad. The public should not be allowed to even think about the possibility that smoking may NOT be bad. That is why the question is not asked, and another reason why the public should be wary about anything claimed by the anti-smoker prohibition industry.

    Simple explanation as to why the anti-smoker campaign is failing - You can fool some of the people all of the time and all of the people some of the time, but you cannot fool all the people all the time!

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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