Measuring Cigarette Smoking Risk Perceptions

Abstract

Risk perception is an important construct in many health behavior theories. Smoking risk perceptions are thoughts and feelings about the harms associated with cigarette smoking. Wide variation in the terminology, definition, and assessment of this construct makes it difficult to draw conclusions about the associations of risk perceptions with smoking behaviors. To understand optimal methods of assessing adults’ cigarette smoking risk perceptions (among both smokers and nonsmokers), we reviewed best practices from the tobacco control literature, and where gaps were identified, we looked more broadly to the research on risk perceptions in other health domains. Based on this review, we suggest assessments of risk perceptions (1) about multiple smoking-related health harms, (2) about harms over a specific timeframe, and (3) for the person affected by the harm. For the measurement of perceived likelihood in particular (ie, the perceived chance of harm from smoking based largely on deliberative thought), we suggest including (4) unconditional and conditional items (stipulating smoking behavior) and (5) absolute and comparative items and including (6) comparisons to specific populations through (7) direct and indirect assessments. We also suggest including (8) experiential (ostensibly automatic, somatic perceptions of vulnerability to a harm) and affective (emotional reactions to a potential harm) risk perception items. We also offer suggestions for (9) response options and (10) the assessment of risk perception at multiple time points. Researchers can use this resource to inform the selection, use, and future development of smoking risk perception measures. Implications Incorporating the measurement suggestions for cigarette smoking risk perceptions that are presented will help researchers select items most appropriate for their research questions and will contribute to greater consistency in the assessment of smoking risk perceptions among adults.

Comparison of a General and Conditional Measure of E-Cigarette Harm Perceptions

“…How harmful do you think this vaping would be to your health?”). The latter personalized the behavior and harm to the self (“imagine you vaped”; “ your health”) and presented a specific use condition and timeframe (“daily for the next 10 years; “used no other tobacco product”), following recommendations and measures from previous studies [ 1 , 4 , 6 , 8 ]. In the current study, these two questions were presented to participants on separate online survey pages.…”

“…Tobacco and nicotine product risk and harm perceptions have been associated with tobacco use, and as such, tobacco risk measures are important and frequently included in research studies [ 1 , 2 , 3 ]. However, these measures are often asked in a general way (e.g., “how harmful do you think e-cigarettes are to health?”) [ 1 , 4 ].…”

“…Recent reports and reviews of risk perception studies have recommended the use of more specific wording when measuring tobacco risk and harm perceptions [ 1 , 4 , 5 ]. This includes, for example, the measurement of harm/risk beliefs about specific health effects of a given product, rather than a single general harm or risk perception question [ 1 , 5 , 6 , 7 , 8 , 9 ].…”

“…This includes, for example, the measurement of harm/risk beliefs about specific health effects of a given product, rather than a single general harm or risk perception question [ 1 , 5 , 6 , 7 , 8 , 9 ]. Other recommendations include specifying for whom the risk is being evaluated (i.e., self or others), providing a conditional scenario of use (e.g., specifying the product used and level of exposure or frequency of product use), and providing a timeframe for consideration [ 1 , 4 ]. Providing this type of conditional detail may help to improve the likelihood that respondents are interpreting the question and risk assessment in a similar way, and may also aid in interpretation of responses [ 1 ].…”

“…However, a recent review of tobacco risk perception studies found that few included conditional measures that specified a frequency of product use and a timeframe, and that limited research exists comparing the results of conditional and unconditional tobacco risk measures [ 1 ]. A follow-up review also recommended more research to examine the potential advantage of conditional tobacco measures over unconditional measures and suggested that studies include both types of measures [ 4 ].…”