The Accuracy of Teens' Expectations of Future Smoking

BACKGROUND: Whether current and potential smokers recognize the full scope of smoking-related risks remains in dispute. This paper provides new evidence for one key group, teenagers, by assessing whether teens accurately assess the chances that they will be smoking in the future. Among current smokers, this is one measure of whether they understand the addictiveness of smoking. Among current nonsmokers, this provides evidence regarding the social environment in which teens decide whether to smoke. METHODS: A nationally representative sample of teens was asked to assess the chances that they would be smoking 1 year later. Mean expectations of future smoking were compared with the actual probabilities of smoking initiation or continuation over 1 year from comparable epidemiologic data. RESULTS: Among current smokers, the mean expectation of continued smoking in 1 year was significantly lower than the observed continuation rate (p <0.01). Among nonsmoking teens, the mean expectation of smoking initiation was significantly lower than the observed rate of initiation (p <0.02). Both types of underestimations were substantively large and consistent across the teenage years. CONCLUSIONS: Currently-smoking teens underestimate the chances that they will continue smoking-which is one measure of whether they understand the addictiveness of cigarettes-while currently-nonsmoking teens underestimate the chance that they will start to smoke, a measure of the social appeal of cigarettes. Tobacco control strategies should account for these misperceptions.