Changes in Cancer-Related Risk Perception and Smoking Across Time in Newly-Diagnosed Cancer Patients
We examine the bidirectional relationships between cancer risk perceptions and smoking behavior among newly diagnosed cancer patients (N=188) during hospitalization for surgical resection, and at three and 12 months subsequently. Those with higher perceptions of risk for developing another cancer at three months were most likely to abstain from smoking by twelve months. Patients were relatively accurate in their cancer risk perceptions, with relapsers and continuous smokers reporting higher levels of risk perceptions at twelve months. Finally, those who quit smoking by 12 months felt at lower risk for developing cancer by 12 months. None of these relationships were significant between baseline and three months. Results indicate that perceived risk of cancer recurrence may be clinically useful in motivating smoking cessation after the acute cancer treatment phase is over. This study justifies an expanded theoretical framework attending to the distinct, prospective influences of illness risk perceptions on health behavior, and of health behavior on illness risk perceptions.
KEY WORDSrisk perceptions health behavior theory smoking cessation
This work was supported by NIH grants R29 CA70830, T32 CA0009461, and K07 CA098106. We thank Jane Gooen-Piels, Ph.D., Peggy Maher, Ph.D., Sunita Mohabir, M.A., Valerie Rusch, M.D., and Ashok Shaha M.D. for their support in conducting the study, as well as Jennifer Ford, Ph.D. and Kevin McCaul, Ph.D., for their helpful comments on the manuscript.
- Agresti, A. (2002). Categorical data analysis, 2nd ed. Wiley, New York.Google Scholar
- Ajzen, I., and Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Prentice Hall, New Jersey.Google Scholar
- Bandura, A. (1986). Social foundations of thought and action: A Social Cognitive Theory. Prentice Hall, New Jersey.Google Scholar
- Fagerstrom, K. O., Heatherton, T. F., and Kozlowski, L. T. (1990). Nicotine addiction and its assessment. Ear, Nose, Throat J. 69: 763–765.Google Scholar
- Horowitz, A. M., Nourjah, P., and Gift, H. C. (1995). U.S. adult knowledge of risk factors and signs of oral cancers: 1990. J. Am. Dental Assoc. 126: 39–45.Google Scholar
- Hsu, J. C. (1996). Multiple comparisons: Theory and methods. Chapman & Hall, London.Google Scholar
- McCullagh, P., and Nelder, J. A. (1999). Generalized linear models, 2nd ed. Chapman & Hall, New York.Google Scholar
- Rogers, R. W. (1983). Cognitive and physiological processes in attitude change 1983. A revised theory of protection motivation. In Cacioppo, J., and Petty, R. (Eds.), Social Psychophysiology. Guilford Press, New York, pp. 153–176.Google Scholar
- Sutton, S. R. (1982). Fear-arousing communications: A critical examination of theory and research. In Eiser, J. R. (Ed.), Social Psychology and Behavioral Medicine. Wiley, Chichester, pp. 303–338.Google Scholar
- Vernon, S. (1999). Risk perception and risk communication for cancer screening behaviors: A review. J. Natl. Cancer Inst. 25: 101–118.Google Scholar
- Weinstein, N. D., Rothman A. J., and Nicolich, M. (1998). Use of correlational data to examine the effects of risk perception on precautionary behaviors. Psychol. Health 13: 479– 501.Google Scholar