Perceptions of Smoking-Related Risks and Benefits as Predictors of Adolescent Smoking Initiation

Objectives. We used prospective, longitudinal data to directly test whether smoking-related perceptions predict smoking initiation among adolescents. Methods. 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. Results. 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 smoking. Adolescents who held the highest perceptions of smoking-related benefits were 3.31 times more likely to initiate smoking. Conclusions. Smoking initiation is directly related to smoking-related perceptions of risks and benefits. Efforts to reduce adolescent smoking should continue to communicate the health risks of smoking and counteract perceptions of benefits associated with smoking. (Am J Public Health. 2009;99:487-492. doi: 10.2105/AJPH.2008.137679)