Self-exempting beliefs about smoking and health: differences between smokers and ex-smokers

Am J Public Health. 1993 Feb;83(2):215-9. doi: 10.2105/ajph.83.2.215.


Objectives: The purpose of the present study was to examine the role of self-exempting or cognitive dissonance-reducing beliefs about smoking and health. Such beliefs may hold important implications for the content and targeting of health promotion campaigns.

Methods: A survey of smokers and ex-smokers was conducted in western Sydney, Australia. Six hypotheses were tested.

Results: The principal findings were (1) that 27.9% of smokers and 42.1% of ex-smokers agreed that smokers were more likely than non-smokers to get five smoking-related diseases; (2) that for 11 of 14 beliefs tested, more smokers than ex-smokers agreed to a statistically significant degree; (3) that the median number of such beliefs agreed to by smokers was five, compared with three for ex-smokers; (4) that for only 5 of 14 beliefs was agreement expressed by more precontemplative smokers than smokers contemplating or taking action to quit; (5) that more than one in four smokers, despite agreeing that smokers are more likely than non-smokers to get five diseases, nonetheless maintain a set of self-exempting beliefs.

Conclusions: Fewer smokers than ex-smokers accept that smoking causes disease, and smokers also maintain more self-exempting beliefs. Becoming an ex-smoker appears to involve shedding such beliefs in addition to accepting information about the diseases caused by smoking.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health*
  • Cognitive Dissonance
  • Female
  • Humans
  • Male
  • Smoking / adverse effects
  • Smoking / psychology*
  • Smoking Cessation / psychology*
  • Social Class