Do Risk-Minimizing Beliefs about Smoking Inhibit Quitting?

Findings from the International Tobacco Control (ITC) Four-Country Survey

This study used data gathered from 13,324 adults who participated in a four-country survey that took place in three waves. The authors had two aims: to validate a finding from previous studies, that people who hold beliefs minimizing the risks of smoking have fewer intentions to quit, and to determine whether agreement with such statements can prospectively predict who will not quit smoking.

Beliefs were broken down into two categories: risk-minimizing and self-exempting beliefs. Risk minimizing beliefs were categorized by agreement with statements such as “the medical evidence that smoking is harmful is exaggerated” and self-exempting beliefs were characterized by statements such as “I must have...good health or genes that mean I can smoke without getting any of the harms”. The authors’ analyses confirmed findings from earlier studies that rationalizing beliefs are related to intentions to quit, and that such beliefs are most strongly held among older smokers and smokers from lower-socioeconomic profiles. Also, rationalizing beliefs were predictive of subsequent attempts to quit smoking. Self-exempting beliefs, however, were not associated with attempts to quit.

One implication of this study is that encouragement of smokers to quit should include challenging self-rationalizing beliefs about harms of smoking. Since self-exempting beliefs were not associated with attempts to quit, targeting these beliefs as a means of getting smokers to stop smoking may not be worthwhile. Lastly, because lower-socioeconomic status smokers seem to strongly hold rationalizing beliefs that minimize the harms of smoking, attempts to target such thinking in this particular demographic are worth making.