Chen Lei-Shih, Kaphingst Kimberly A, Tseng Tung-Sung, Zhao Shixi
Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
Department of Communication, University of Utah, Salt Lake City, UT, USA.
Transl Cancer Res. 2016 Oct;5(Suppl 5):S964-S971. doi: 10.21037/tcr.2016.10.75.
Subjective risk perception is an important theoretical construct in the field of cancer prevention and control. Although the relationship between subjective risk perception and health behaviors has been widely studied in many health contexts, the causalities and associations between the risk perception of developing lung cancer and cigarette smoking have been inconsistently reported among studies. Such inconsistency may be from discrepancies between study designs (cross-sectional versus longitudinal designs) and the three hypotheses (i.e., the behavior motivation hypothesis, the risk reappraisals hypothesis, and the accuracy hypothesis) testing different underlying associations between risk perception and cigarette-smoking behaviors. To clarify this issue, as an initial step, we examined the association between absolute and relative risk perceptions of developing lung cancer and cigarette-smoking behaviors among a large, national representative sample of 1,680 U.S. adults by testing an accuracy hypothesis (i.e., people who smoke accurately perceived a higher risk of developing lung cancer).
Data from the U.S. Health Information National Trends Survey (HINTS) were analyzed using logistic regression and multivariate linear regression to examine the associations between risk perception and cigarette-smoking behaviors among 1,680 U.S. adults.
Findings from this cross-sectional survey suggest that absolute and relative risk perceptions were positively and significantly correlated with having smoked >100 cigarettes during lifetime and the frequency of cigarette smoking. Only absolute risk perception was significantly associated with the number of cigarettes smoked per day among current smokers.
Because both absolute and relative risk perceptions are positively related to most cigarette-smoking behaviors, this study supports the accuracy hypothesis. Moreover, absolute risk perception might be a more sensitive measurement than relative risk perception for perceived lung cancer risk. Longitudinal research is needed in the future to investigate other types of risk perception-risk behavior hypotheses-the behavior motivation and the risk reappraisals hypotheses-among nationally representative samples to further examine the causations between risk perception of obtaining lung cancer and smoking behaviors.
主观风险认知是癌症预防与控制领域的一个重要理论概念。尽管在许多健康背景下，主观风险认知与健康行为之间的关系已得到广泛研究，但关于患肺癌风险认知与吸烟之间的因果关系和关联，各研究报告并不一致。这种不一致可能源于研究设计（横断面研究与纵向研究设计）的差异，以及检验风险认知与吸烟行为之间不同潜在关联的三个假设（即行为动机假设、风险重新评估假设和准确性假设）。为了阐明这一问题，作为第一步，我们通过检验准确性假设（即吸烟者准确感知到患肺癌的风险更高），在一个由1680名美国成年人组成的、具有全国代表性的大样本中，研究了患肺癌的绝对风险认知和相对风险认知与吸烟行为之间的关联。
使用美国健康信息全国趋势调查（HINTS）的数据，通过逻辑回归和多元线性回归分析，研究1680名美国成年人中风险认知与吸烟行为之间的关联。
这项横断面调查的结果表明，绝对风险认知和相对风险认知与终生吸烟超过100支以及吸烟频率呈正相关且具有显著相关性。在当前吸烟者中，只有绝对风险认知与每日吸烟量显著相关。
由于绝对风险认知和相对风险认知均与大多数吸烟行为呈正相关，本研究支持准确性假设。此外，对于感知到的肺癌风险，绝对风险认知可能比相对风险认知是更敏感的衡量指标。未来需要进行纵向研究，以在全国代表性样本中调查其他类型的风险认知-风险行为假设——行为动机假设和风险重新评估假设——以进一步研究患肺癌风险认知与吸烟行为之间的因果关系。
