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Perspectives in Disease Prevention and Health Promotion Smokers' Beliefs about the Health Benefits of Smoking Cessation -- 20 U.S. Communities, 1989

The health risks associated with smoking and the reduction in risk associated with smoking cessation are well documented (1,2). Although public knowledge of the health hazards of smoking is high and has increased steadily since the 1950s (1), data are limited regarding public knowledge of the health benefits of smoking cessation. This report presents data on smokers' beliefs about their chances of avoiding disease by quitting smoking.

Data were obtained from a telephone survey conducted from January through April 1989 of a random sample of 4351 smokers aged 25-64 years. The survey was conducted in 20 communities* in the United States as part of the National Cancer Institute's Community Intervention Trial for Smoking Cessation (3). Interviews were completed with 3669 (84%) eligible smokers regarding their knowledge, attitudes, and behavior relevant to cigarette smoking. For this report, responses to two items were analyzed: 1) "How likely do you think it is that you will avoid or decrease serious health problems from smoking if you quit?" (four response choices ranged from "very likely" to "very unlikely"); and 2) "If a person has smoked for more than 20 years, there is little health benefit to quitting" (four response choices ranged from "strongly agree" to "strongly disagree"). Responses were examined in relation to sex, age, level of education (high school graduate or less vs. some college or more), and daily cigarette consumption ( less than 25 or greater than or equal to 25 cigarettes per day).

Overall, 83% of smokers responded that it was "very likely" or "likely" that by quitting they would avoid or decrease serious health problems from smoking. Eighty-five percent of smokers disagreed that little health benefit exists from quitting for a person who has smoked greater than 20 years. For both items, beliefs about the benefits of quitting varied by age and education but not by sex. Within each age group, respondents who had attended college were more likely to both perceive benefits and disagree that there is little benefit from quitting than were those who had not (p less than 0.05, chi-square test) (Figure 1); this difference increased with age. For smokers with no college education, 87% of those aged 25-34 years and 67% of those aged 55-64 years believed they would avoid or decrease serious health problems by quitting (p less than 0.05). For college-educated smokers, age group differences did not vary significantly (Figure 1). Reported by: KM Cummings, PhD, R Sciandra, Dept of Cancer Control and Epidemiology, Roswell Park Cancer Institute, Buffalo, New York, and TF Pechacek, PhD, WR Lynn, National Cancer Institute, National Institutes of Health, for the Community Intervention Trial for Smoking Cessation Research Group. Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: Former smokers most frequently cite concern about health as the reason for quitting smoking (4). Although most of the public is aware of the health risks associated with smoking and the health benefits of smoking cessation, smokers tend to be less aware of these risks and benefits, and sizable gaps in public knowledge persist in certain sociodemographic groups.

Educational level appears to be the best sociodemographic predictor of smoking behavior. Cessation rates are higher for college-educated than for noncollege-educated groups, a disparity that appears to be increasing (1,5). Educational status may be linked to attitudes and values that predispose a person to accept or reject warnings about tobacco use and may reflect exposure to antismoking messages (6). Future antismoking campaigns need to be more sensitive to educational status when defining messages and selecting communication channels.

Knowledge of the benefits of smoking cessation was lowest in smokers aged 55-64 years who had no college education. Thus, greater attention must be directed at informing this group about the health benefits of quitting smoking.

CDC's Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion (CCDPHP), is initiating a public information campaign on the health benefits of smoking cessation for older Americans based on the theme "It's never to late to quit smoking." The program is being conducted in collaboration with the National Institutes of Health, the Administration on Aging, the Department of Veterans Affairs, the Office of Disease Prevention and Health Promotion, the American Association of Retired Persons, and the Fox Chase Cancer Center. Information on this campaign and print materials are available from the Office on Smoking and Health, CCDPHP, CDC, 5600 Fishers Lane, Rockville, MD 20857; telephone (301) 443-5287.

References

  1. CDC. Reducing the health consequences of smoking: 25 years of progress--a report of the Surgeon General, 1989. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1989; DHHS publication no. (CDC)89-8411.

  2. CDC. The health benefits of smoking cessation: a report of the Surgeon General, 1990. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1990; DHHS publication no. (CDC)90-8416.

  3. Pechacek TF. A randomized trial for smoking cessation. In: Smoking and health, 1987--proceedings of the sixth World Conference on Smoking and Health. New York: Excerpta Medica, 1988:241-3.

  4. CDC. Tobacco use in 1986: methods and basic tabulations from Adult Use of Tobacco Survey. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1990.

  5. Pierce JP, Fiore MC, Novotny TE, Hatziandrev EJ, Davis RM. Trends in cigarette smoking in the United States: educational differences are increasing. JAMA 1989;261:56-60.

  6. Warner KE. Selling smoke: cigarette advertising and public health. Washington, DC: American Public Health Association, 1986.

    • Bellingham and Longview/Kelso, Washington; Albany/Corvallis and Medford/Ashland, Oregon; Vallejo and Hayward, California; Santa Fe and Las Cruces, New Mexico; Cedar Rapids and Davenport, Iowa; Raleigh and Greensboro, North Carolina; Paterson and Trenton, New Jersey; Yonkers, New Rochelle, Utica, and Binghamton/Johnson City, New York; and Lowell and Fitchburg/Leominster, Massachusetts.



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