As tobacco companies settle lawsuits filed by
states seeking to recover money spent treating smoking-related
illnesses, the agreements, most likely, will call for the
establishment of effective smoking-cessation programs. The challenge,
then, will be to create the most effective programs.
In that light, researchers at Duke University Center for Health,
Policy, Law and Management have initiated a study that will examine
smoking risk perceptions and behavior change in long-term smokers
ages 51 to 64 years. In particular, the study, funded by a $350,000
grant from The Robert Wood Johnson Foundations Substance Abuse
Policy Research Program, will try to determine what combination of
informational messages and price hikes will prompt smokers to quit.
"There are multiple reasons for investigating this. One, of
course, is not everyone responds to the same sort of incentives,"
said Kerry Smith,PhD, a professor of environmental economics at
Duke, who is the lead researcher on the project.
Teenage smokers, for instance, would be more likely to give up
cigarettes if tax hikes raise the price significantly. Older smokers,
on the other hand, may be more responsive to specific messages that
clearly spell out the health risks associated with smoking,
especially if they or a family member developed a smoking-related illness.
"The evidence thats available to this point suggests that
older individuals will not only be less responsive to price, but may
actually substitute low-tar cigarettes with higher-tar, more harmful
cigarettes if the price goes up," Dr. Smith said. "They may
respond by smoking somewhat less, but smoking more harmful
cigarettes. The net health effect, then, will not necessarily decline."
How Perceptions Translate Into Actions
In the study, researchers will examine data from the University of
Michigans Health and Retirement Study, a federally funded
national questionnaire that compares the perceptions of risk every 2
years among the same group of current and former smokers and
nonsmokers. Duke researchers, along with economists from Triangle
Economic Research of Durham, North Carolina, are also devising their
own study to delve further into these issues in an attempt to gain a
better understanding of how a perception of risk is actually
translated into action.
"How perceptions actually influence smoking behavior is crucial
to judging whether information-based efforts are likely to prove
successful," the researchers said in their project narrative.
"We want to transform our understanding of how people make
Frank Sloan, PhD, director of the Center for Health Policy, Law and
Management at Duke, said the current messages that the American
public receives about cigarettes are too general, eg, "that the
surgeon general has determined that smoking is hazardous to your
health." "Those messages dont suggest anything about
the sequence of health effects that accompany heart disease or lung
disease or the other serious respiratory-related ailments that limit
ones activities and are associated with smoking," Dr.
Sloan said. "They dont mention how smoking can impede your
activity for long periods of time and cause considerable pain and suffering."
Better Response With Strong, Specific Messages
"Its the more specific messages that have proven in other
research to be far more effective in getting people to understand the
full consequences of their actions and change the way in which they
use information about risk."
Dr. Smith explained that while adults may understand that smoking is
a hazardous activity, they may not "internalize that fact. They
may believe that theyll be the better-than-average person"
who does not develop smoking-related health problems. In that case,
he said, it may be that smokers are processing information
differently from nonsmokers.