Predicting Adolescent Perceptions of the Risks and Benefits of Cigarette Smoking: A Longitudinal Investigation

Objective: To evaluate developmental changes, personal smoking experiences, and vicarious smoking experiences as predictors of adolescents' perceptions of the risks and benefits of cigarette smoking over time, and to identify new and effective targets for youth smoking prevention programs. Design: There were 395 adolescents surveyed every 6 months for two school years, from the beginning of 9th grade to the end of 10th grade. Main Outcome Measures: Time, participant smoking, friend smoking, parental smoking, and sex were evaluated as predictors of smoking-related short-term risk perceptions, long-term risk perceptions, and benefits perceptions using multilevel modeling techniques. Results: Perceptions of benefits did not change over time. Perceptions of risk decreased with time, but not after sex and parental smoking were included in the model. Adolescents with personal smoking experience reported decreasing perceptions of risk and increasing perceptions of benefits over time. Adolescents with more than 6 friends who smoked also reported increasing perceptions of benefits over time. Conclusions: Changes in risk perceptions may not purely be the result of developmental processes, but may also be influenced by personal and vicarious experience with smoking. Findings highlight the importance of identifying and targeting modifiable factors that may influence perceptions.