Perceptions of smoking-related risks and benefits as predictors of adolescent smoking initiation

The predictive value of perceptions of smoking-related risks and benefits with regard to adolescent smoking initiation has not been adequately established. We used prospective, longitudinal data to directly test whether smoking-related perceptions predict smoking initiation among adolescents.

We administered surveys assessing perceptions of smoking-related risks and benefits to 395 high school students, beginning at the start of their ninth-grade year. We conducted follow-up assessments every 6 months until the end of 10th grade, obtaining 4 waves of data.

Adolescents who held the lowest perceptions of long-term smoking-related risks were 3.64 times more likely to start smoking than were adolescents who held the highest perceptions of risk. Adolescents who held the lowest perceptions of short-term smoking-related risks were 2.68 times more likely to initiate. Adolescents who held the highest perceptions of smoking-related benefits were 3.31 times more likely to initiate.

Findings from this study provide one of the first sets of empirical evidence to show that smoking initiation is directly related to smoking-related perceptions of risks and benefits. Thus, efforts to reduce adolescent smoking should continue to communicate the health risks of smoking and counteract perceptions of benefits associated with smoking.