Smoking and risk perception of natural and biological hazards: Challenging risk classification in public health

Understanding how individuals perceive risks of natural and health hazards can improve risk communication. This study aimed to investigate perceptions of natural and biological hazards among smokers and non-smokers, using smoking as a proxy for risk-taking propensity. A cross-sectional survey was conducted in Italy and Sweden in August 2021 with representative samples (n = 4,131). Risk perception across seven hazards was measured using Likert scales. Ordinal logistic regression was used to assess associations between smoking and risk perception, stratified by country and adjusted for sociodemographic confounders. Smoking prevalence was higher in Italy (32.7%) than Sweden (8.8%). In Italy, smokers, particularly moderate-heavy smokers, perceived higher hazard risks than non-smokers. No such pattern was found in Sweden. Contrary to the initial hypothesis, smoking was associated with heightened risk perception in Italy. This study challenges traditional categorizations of risk-seeking versus risk-averse individuals, emphasizing the complex interplay of individual behaviors, perceptions, and societal norms.