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Risk Perceptions, Information and Smoking

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Project Summary:

The purpose of the research is to better understand how informational messages can be used to encourage cigarette smoking cessation. We will obtain a better understanding of how people update individual perceptions of risk over time, given new information and life events such as health shocks, and how this relates to smoking behavior. This is clearly important because proposed federal legislation limiting liability for U.S. tobacco companies relies on informational messages to encourage cessation as well as to prevent young persons from starting smoking. It is not clear how smokers differ from nonsmokers in terms of information processing and the effect of information on updating personal risk perceptions. Smokers may also differ systematically in ways relevant to the design of improved smoking cessation policies. The study has 5 main objectives: (1) to develop a consistent behavioral model linking risk updating and information to behavior; (2) to estimate the effectiveness of smoking-risk information to influence behavior; (3) to evaluate how a partner influences risk updating and smoking behavior; (4) to reconcile past inconsistencies about the effect of information on behavior; and (5) to interpret our results in a manner that will inform future smoking cessation efforts. The study will take advantage of 2 existing national panel surveys that elicited information related to individual risk perceptions across time. These surveys, 4 waves of the Health and Retirement Study (HRS, subject ages 51-61) and 3 waves of the Asset and Health Dynamics of the Oldest Old (AHEAD, subject ages 70+) survey provide the most comprehensive evidence to date of how risk perceptions change over time as a consequence of intervening events such as health shocks. Preliminary evidence from our analysis of the first two waves of the HRS data base suggests that smokers process information differently from nonsmokers and former smokers. In particular, they are less likely to adjust risk perceptions related to their age of death given the onset of general health problems between waves of the survey. Interestingly, when the health problems are smoking-related, smokers do revise downward their perception of the likelihood they will survive to 75 or 85 years of age in a manner similar to nonsmokers. To compensate for inadequacies of the HRS and AHEAD data bases to fully answer our study objectives, we will develop and field a stated-preference (SP) survey, which will be informed by our analysis of HRS and AHEAD. The SP survey of smokers and former smokers aged 51-65, demographically matched to the HRS sample, will be undertaken in two phases: (1) a computer-assisted in person interview that presents specific risk and informational messages while collecting smoking status, attitudes, risk perceptions and other information; and (2) a short follow up telephone re-survey after 6 months to evaluate risk updating and smoking status in response to information received in the initial survey. Questions shared with the HRS include perceptions of risk, health status, demographics, and income, which will allow us to link the responses from the SP survey to this large national data base. This study will potentially make several important contributions. We will link receipt of information and updating of life expectancy to behavioral change observed over time. We will gain a better understanding of the heterogeneity in response to health shocks and informational messages. Using a sample matching process, we will expand the scope of expectation questions that have been previously asked. We will communicate our findings in a form that will be highly useful to public policymakers and to health professionals/educators involved in the design and implementation of smoking-cessation programs and related activities.

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