Most smokers do not perceive themselves at increased risk of experiencing heart disease or developing cancer. That’s according to an article previously published in The Journal of the American Medical Association (JAMA).
John Z. Ayanian, M.D., M.P.P., of Brigham and Women’s Hospital, and Paul D. Cleary, Ph.D., of Harvard Medical School, both in Boston, conducted a survey to assess smokers’ perceptions of their risks of heart disease and cancer. The survey included 3,031 adults aged 25 to 74 years, including 737 current smokers (24.3 percent).
The authors found that only 29 percent of current smokers in the study believed they have a higher-than-average risk of myocardial infarction (MI, or heart attack), while only 40 percent believed they have a higher-than-average risk of cancer. The researchers also found that only 39 percent of heavy smokers (greater than 40 cigarettes per day) acknowledged the increased risk of MI and 49 percent acknowledged the increased risk of cancer. Among smokers who had hypertension or a family history of MI, fewer than half perceived their risk of MI as higher than average (48 percent and 39 percent, respectively).
The authors also found that older (age 65 or older), less educated (did not graduate from high school) and light smokers (1-19 cigarettes per day) were less likely than younger, more educated and heavy smokers to perceive an increased personal risk of MI or cancer.
“Despite past efforts to educate smokers about their health risks, our nationally representative study demonstrates that most smokers — even heavy smokers and those with other cardiac risk factors — do not perceive themselves at increased risk of experiencing an MI or developing cancer,” the authors write. “Consistent with prior studies of less-representative cohorts, many smokers continue to deny their own personal risks from smoking.”
According to the authors, cigarette smoking causes more preventable deaths from cardiovascular disease and cancer than any other modifiable risk factor. Smokers who quit reduce their risk of these conditions and prolong their lives substantially, but approximately 48 million U.S. adults continue to smoke. Physicians’ advice may help smokers assess their personal health risks more realistically, but many smokers have not received such advice.
“As a foundation for smoking cessation efforts, physicians and health educators should assess smokers’ risk perceptions and provide more intensive counseling to those who underestimate their personal health risks, particularly older and less-educated smokers,” write the authors. “Although physician counseling remains a cost-effective method to promote smoking cessation, alternative strategies will be needed to help smokers who have greater difficulty quitting and motivate the one-third of smokers who do not have access to a regular physician.”
Apparently, physicians and public health professionals need to educate smokers of potential risks.
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