Concern about future health problems goes up in smoke

September 03, 2002

Knowing the long-term health benefits of quitting and the long-term harm of continued smoking may not be enough incentive for some smokers to kick the habit, according to a new study in the August issue of the journal Nicotine & Tobacco Research.

Smokers need to see more immediate results if their attempts to quit will be successful, suggests study author Amy L. Odum, Ph.D., now at the University of New Hampshire.

Smokers don't place as much value on the risks of future health problems as nonsmokers do, she says, explaining that "cigarette smokers are less sensitive to the future health consequences of their behavior. In particular, they are less sensitive to health losses than health gains. This means that to be effective, therapies might focus on future health gains (like easier breathing and longer life) more so than future health losses (like lung cancer and emphysema)."

Odum and her colleagues evaluated 23 current cigarette smokers (who smoked at least 20 cigarettes a day for the past five years), 21 ex-smokers (who hadn't smoked for at least a year), and 22 people who had never smoked to compare the groups' different values on health issues.

To test the participants' values, they were given scenarios about having a serious sexually transmitted disease, a health problem the researchers chose because it is not related to smoking and therefore equally likely for all participants. In one scenario, designed to see how they weighed future health gains, they were told to imagine they were sick right now but could get well later. In another, designed to see how they weighed future health losses, they were told to imagine they were well right now, but could get sick later.

Smokers placed less value on future damage to their health than did nonsmokers. For example, the smokers said they would rather deal with a chronic illness for a longer period of time, 10 years versus 8 and a half, if they could put the illness off for a year.

Smokers did seem to value potential long-term health benefits above the threat of poor health, Odum says.

In general, she says, the study emphasizes the need for smoking cessation therapies that illustrate the immediate consequences of not smoking, rather than relying on possible benefits in the distant future. For example, contingency management therapy, in which people are checked regularly to verify their smoking status using physiological measures and then given vouchers for consumer goods and services if they haven't smoked, has proven successful.

"This type of therapy can help get people through the difficult initial periods of quitting, to the point where they can start getting some of the more delayed benefits of not smoking, like better health," says Odum.
The study was funded in part by National Institute on Drug Abuse grants.

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