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
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.
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.
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.
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.
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.
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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