DESCRIPTION (provided by applicant): Do smokers truly appreciate the health risks they undertake by smoking? The answer to this question has profound implications for health educational programs, smoking cessation programs, and public health policy, as well as law suits against tobacco companies. Research shows that adult U.S. smokers who believe they are personally at risk for smoking-related illnesses (such as lung cancer) are more likely to engage in smoking cessation efforts. However, we know little about how people come to believe that they are personally at risk and the role that cultural messages play. One important cultural factor is moralization the individual and cultural process by which preferences are converted into values. Research shows that in the U.S. smoking has become a behavior that is regarded as a moral act (smoking is viewed as inherently bad) rather than a personal choice. Moralization might create an abundance of cultural messages about the dangers of smoking which in turn might increase people's perceptions of how dangerous it is to smoke (dangerous to the smoker and to others). Both moralization and risk perceptions might thus in turn influence smoking cessation. The effects of moralization can best be studied by comparing cultures that differ in this respect, such as the U.S. (a smoking-prohibitive culture where smoking is moralized) and Denmark (a smoking-lenient culture where smoking is much less moralized). In the proposed research two studies in the U.S. and Denmark will examine the link between moralization, risk perceptions, and smoking cessation. Study 1 a qualitative interview study among U.S. and Danish smokers will examine whether smokers' perceptions of being targets of moralization (including feelings of stigmatization and social disapproval) are associated with risk perceptions of smoking (risks to themselves and others) and risk reducing behaviors such as quitting, limiting, or reducing smoking (Specific Aim 1). Study 2 a longitudinal survey study among U.S. and Danish smokers and non-smokers will examine the extent to which individual moralization predicts risk perceptions of smoking (risks to themselves and others) (Specific Aim 2) and will examine how these factors among smokers predict risk reducing behaviors such as quitting, limiting, or reducing smoking 6 months later (Specific Aim 3). Understanding cultural origins of risk information and smoking cessation is particularly important in the U.S. with its large and diverse immigrant and refugee populations. This research will lay the groundwork for more effective smoking cessation programs and thereby contribute to reaching the Healthy People 2010 objective of reducing adult cigarette smoking in the U.S. to 12%. PUBLIC HEALTH RELEVANCE: This research will provide valuable insights to the relationships among culture, risk perception, and smoking cessation and thus lay the groundwork for more effective educational interventions and smoking cessation programs. Understanding cultural origins of risk information and smoking cessation is particularly important in the U.S. with its large and diverse immigrant and refugee populations. This research will contribute to reaching the Healthy People 2010 objective of reducing adult cigarette smoking in the U.S. to 12% from the 2006 rate of 21%.
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