Associations of Daily Versus Nondaily Smoking, Tobacco-Related Risk Perception, and Cancer Diagnosis Among Adults in the Population Assessment of Tobacco and Health (PATH) Study

Abstract

Introduction Nondaily smoking has become increasingly common among cigarette smokers. Our objective was to determine whether current daily versus nondaily smoking differed by tobacco-related risk perceptions (TRRPs), demographic factors, and cancer history. Methods Participants were all adult current smokers in three consecutive years (Waves 1–3) of the longitudinal cohort Population Assessment of Tobacco and Health Study (N=8,307). The primary analysis was weighted logistic regression of daily versus nondaily smoking at Wave 3. TRRP measures were cigarette harm perception, worry that tobacco products will damage one’s health, belief that smoking cigarettes causes [lung/bladder/mouth/liver] cancer, and nondaily cigarette harm perception (Likert-type scale). Other measures included demographic factors, other tobacco product use, minor at time of first cigarette, and cancer survivor status (yes/no). Results Among current smokers, daily versus nondaily smoking was significantly associated with being a minor at time of first cigarette (OR=1.54, p<.001), TRRPs (OR=0.83, p<.001; OR=1.40, p<.001; and OR=1.17, p=.009 [harm perception, worry, and nondaily cigarette harm perception, respectively]), and interaction between cancer survivor status and belief that smoking causes cancer (p<.001). TRRPs among current smokers did not differ significantly between cancer survivors and respondents without a cancer history. Conclusions Respondents with lower harm perception, higher worry, and higher nondaily cigarette harm perception were more likely to be daily versus nondaily smokers. Respondents with higher belief that smoking causes cancer or who were cancer survivors were less likely to be daily (versus nondaily) smokers compared to respondents with low belief and no cancer history. Implications This study is unique in that it examined associations of smoking cigarettes daily versus nondaily with tobacco-related risk perceptions and cancer survivorship—comparing cancer survivors to those without a cancer history. Given the increasing prevalence of nondaily smoking as compared with daily smoking in the general population, and the prognostic significance of smoking after cancer diagnosis, these findings fill a clinically important gap in the literature and provide a foundation for further research.

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“…Tobacco use causes more than seven million deaths annually from various life-threatening disorders, such as heart disease, different types of cancer, pulmonary disease, and exacerbation of multiple chronic health conditions ( Land et al, 2022 ). Despite awareness of its consequences on health and intensive prevention and treatment efforts, a large proportion of the population still initiates and continues to smoke ( Agaku et al, 2020 ).…”

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“…As many as 40% of adult smokers in the US are nondaily smokers, 43,66 and their share of smokers has been on the increase. 44 The prevalence of nondaily smoking is higher among younger adults, 67 who are also the most likely age cohort to use ENDS. 45 Importantly, research on nondaily smokers suggests that they are a relevant target for behavior change in the interest of prevention.…”

“…As many as 40% of adult smokers in the US are nondaily smokers, 43,66 and their share of smokers has been on the increase 44 . The prevalence of nondaily smoking is higher among younger adults, 67 who are also the most likely age cohort to use ENDS 45 …”