Absolute and comparative cancer risk perceptions among smokers in two cities in China

Nicotine Tob Res. 2014 Jun;16(6):899-903. doi: 10.1093/ntr/ntu028. Epub 2014 Mar 25.


Introduction: Knowledge about health effects of smoking motivates quit attempts and sustained abstinence among smokers and also predicts greater acceptance of tobacco control efforts such as cigarette taxes and public smoking bans. We examined whether smokers in China, the world's largest consumer of cigarettes, recognized their heightened personal risk of cancer relative to nonsmokers.

Methods: A sample of Chinese people (N = 2,517; 555 current smokers) from 2 cities (Beijing and Hefei) estimated their personal risk of developing cancer, both in absolute terms (overall likelihood) and in comparative terms (relative to similarly aged people).

Results: Controlling for demographics, smokers judged themselves to be at significantly lower risk of cancer than did nonsmokers on the comparative measure. No significant difference emerged between smokers and nonsmokers in absolute estimates.

Conclusions: Smokers in China did not recognize their heightened personal risk of cancer, possibly reflecting ineffective warning labels on cigarette packs, a positive affective climate associated with smoking in China, and beliefs that downplay personal vulnerability among smokers (e.g., I don't smoke enough to increase my cancer risk; I smoke high-quality cigarettes that won't cause cancer).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • China
  • Cities
  • Demography
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Judgment
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / psychology*
  • Risk
  • Smoking / adverse effects
  • Smoking / psychology*
  • Surveys and Questionnaires
  • Young Adult