Self-reported health status, health vulnerability, and smoking behavior in college students: implications for intervention.

Health-related factors, including prevalence of respiratory symptoms and perceived health status, were analyzed by smoking status and by stages of change for quitting to evaluate their potential use as motivators for tobacco cessation. Data were obtained from a survey of 1,283 Houston-area community college students. Respiratory symptoms were most frequent among current smokers and least frequent among never smokers. A higher prevalence of reported respiratory symptoms was associated with being in later stages of readiness to change. An "optimism bias" regarding smoking-related health was evident among smokers; over half of the current smokers believed that their health was better than the average same-age smoker's health, and 19% believed that their health was better than that of the same-age nonsmoker. Furthermore, virtually all of the smokers perceived that their health was either not at all or only slightly affected by smoking, and almost half of smokers thought that quitting would bring either no benefit or only minor benefit to their health. Of the smokers, 45% believed that continuing to smoke would have only minor or no impact on their health. Differences in perceived health vulnerability were observed across the various stages of readiness to quit; precontemplators reported the lowest perceptions of health vulnerability related to smoking, and those in the preparation stage reported the highest perceptions of vulnerability. Smoking cessation counselors should consider measuring and demonstrating the early tobacco-attributable health problems to young smokers to possibly enhance motivation to quit.