Risk Perception Among Smokers: A Qualitative Study

The aim of this qualitative study is to identify the dimensions people used to assess the risk of smoking and then compare them with those used by health professionals in primary healthcare. Five discussion groups were conducted. The field work was carried out in Barcelona (Spain), from February 2005 to January 2006. Data were analyzed following a semantic‐thematic categorical content analysis (ACC‐ts). Results showed that people tend to employ stereotypical discourses when evaluating the risk of smoking. Similarly, they reassess the risk in the context of their life experience and incorporate new nuances to the arguments sustaining their behavior. Once this reassessment takes place, the decision to continue smoking emerges, and smokers come up with additional arguments justifying their habit (i.e., age, benefits related to costs). Professionals are aware of this process and its multidimensional nature. Nevertheless, their discourse loses this multidimensional feature when discussing the strategies they use at smoking cessation interventions. This qualitative study increases the understanding of various meanings that people attribute to their life experience. These assumptions may be useful for developing health practices that are closer to people. As a practical utility of these results, it would be interesting to apply a preliminary assessment of the different meanings that people attribute to smoking from their life context in risk communication.     

Predicting Cancer‐Prevention Behavior: Disentangling the Effects of Risk Aversion and Risk Perceptions

Experimental and survey research spanning the last two decades concludes that people who are more risk tolerant are more likely to engage in risky health activities such as smoking and heavy alcohol consumption, and are more likely to be obese. Subjective perceptions of the risk associated with different activities have also been found to be associated with health behaviors. While there are numerous studies that link risk perceptions with risky behavior, it is notable that none of these controls for risk aversion. Similarly, studies that control for risk aversion fail to control for risk misperceptions. We use a survey of 474 men and women to investigate the influence of risk aversion, risk misperceptions, and cognitive ability on the choice to engage in behaviors that either increase or mitigate cancer risk. We measure optimism in two dimensions: baseline optimists are those who inaccurately believe their cancer risk to be below its expert‐assessed level, while control optimists are those who believe they can reduce their risk of cancer (by changing their lifestyle choices) to a greater extent than is actually the case. Our results indicate that baseline optimism is significantly and negatively correlated with subjects′ tendencies to engage in cancer‐risk‐reducing behaviors, and positively correlated with risky behaviors. Subjects’ control misperceptions also appear to play a role in their tendency to engage in risky and prevention behaviors. When controlling for both of these types of risk misperception, risk aversion plays a much smaller role in determining health behaviors than found in past studies.     

Who is a Distracted Driver? Associations between Mobile Phone Use while Driving,Domain‐Specific Risk Taking,and Personality

Mobile phone use while driving (MPUWD) is an increasingly common form of distracted driving. Given its widespread prevalence, it is important for researchers to identify factors that may predict who is more likely to engage in this risky behavior. The current study investigates associations between MPUWD risk behaviors, domain‐specific risk perceptions, and broad personality dimensions. An Italian community sample (n = 804) completed a survey regarding MPUWD risk perceptions and engagement in MPUWD, in addition to the HEXACO‐PI‐R, a broad six‐factor personality inventory (honesty‐humility, emotionality, extraversion, agreeableness, conscientiousness, openness to experience), and the DOSPERT, a six‐factor domain‐specific self‐report risk‐taking measure (health/safety, recreational, social, ethical, gambling, and investment). With respect to domain‐specific risk taking, greater frequency of SMS use while driving most strongly was associated with greater risk taking for the health/safety, gambling, and ethical risk domains. Further, greater honesty‐humility and conscientiousness, two traits related to cognitive control and risk behaviors, and to a lesser extent openness to experience, were associated with less frequent MPUWD, and positively associated with MPUWD risk perceptions. With growing public safety concern surrounding MPUWD, understanding associated personality factors is not only important for identifying psychological mechanisms underlying risk behavior, but also for more effective prevention and intervention programs.     

Multiple Health Risk Perception and Information Processing Among African Americans and Whites Living in Poverty

We investigated the risk‐information‐processing behaviors of people living at or near the poverty line. Because significant gaps in health and communication exist among high‐ and low‐income groups, increasing the information seeking and knowledge of poor individuals may help them better understand risks to their health and increase their engagement in health‐protective behaviors. Most earlier studies assessed only a single health risk selected by the researcher, whereas we listed 10 health risks and allowed the respondents to identify the one that they worried about most but took little action to prevent. Using this risk, we tested one pathway inspired by the risk information seeking and processing model to examine predictors of information insufficiency and of systematic processing and extended this pathway to include health‐protective action. A phone survey was conducted of African Americans and whites living in the southern United States with an annual income of ≤$35,000 (N= 431). The results supported the model pathway: worry partially mediated the relationship between perceived risk and information insufficiency, which, in turn, increased systematic processing. In addition, systematic processing increased health‐protective action. Compared with whites and better educated respondents, African Americans and respondents with little education had significantly higher levels of information insufficiency but higher levels of systematic processing and health‐protective action. That systematic processing and knowledge influenced health behavior suggests a potential strategy for reducing health disparities.     

Estimation of the Leukemia Risk in Human Populations Exposed to Benzene from Tobacco Smoke Using Epidemiological Data

Several epidemiological studies have demonstrated an association between occupational benzene exposure and increased leukemia risk, in particular acute myeloid leukemia (AML). However, there is still uncertainty as to the risk to the general population from exposure to lower environmental levels of benzene. To estimate the excess risk of leukemia from low‐dose benzene exposure, various methods for incorporating epidemiological data in quantitative risk assessment were utilized. Tobacco smoke was identified as one of the main potential sources of benzene exposure and was the focus of this exposure assessment, allowing further investigation of the role of benzene in smoking‐induced leukemia. Potency estimates for benzene were generated from individual occupational studies and meta‐analysis data, and an exposure assessment for two smoking subgroups (light and heavy smokers) carried out. Subsequently, various techniques, including life‐table analysis, were then used to evaluate both the excess lifetime risk and the contribution of benzene to smoking‐induced leukemia and AML. The excess lifetime risk for smokers was estimated at between two and six additional leukemia deaths in 10,000 and one to three additional AML deaths in 10,000. The contribution of benzene to smoking‐induced leukemia was estimated at between 9% and 24% (U_pperCL 14–31%). For AML this contribution was estimated as 11–30% (U_pperCL 22–60%). From the assessments carried out here, it appears there is an increased risk of leukemia from low‐level exposure to benzene and that benzene may contribute up to a third of smoking‐induced leukemia. Comparable results from using methods with varying degrees of complexity were generated.     

The Value of a Statistical Life for Risk‐Averse and Risk‐Seeking Individuals

This article estimates the value of a statistical life (VSL) for Chile under the hedonic wage method while accounting for individual risk preferences. Two alternative measures of risk aversion are used. First, risk aversion is directly measured using survey measures of preferences over hypothetical gambles, and second, over observed individual behaviors that may proxy for risk preferences, such as smoking status, are used. I reconcile the results with a theoretical model of economic behavior that predicts how the wage‐risk tradeoff changes as risk aversion differs across individuals. The VSL estimates range between 0.61 and 8.68 million dollars. The results using smoking behavior as a proxy for risk attitudes are consistent with previous findings. However, directly measuring risk aversion corrects the wage‐risk tradeoff estimation bias in the opposite direction. The results are robust to other observed measures of risk aversion such as drinking behavior and stock investments. Results suggest that, consistent with the literature that connects smoking behavior with labor market outcomes, smoking status could be capturing poor health productivity effect in addition to purely risk preferences.     

Development and effects of transformational leadership in adolescents

We developed and tested a model in which adolescents who perceive their parents exhibiting transformational leadership behaviors would themselves display these behaviors. In turn, adolescents who used transformational leadership behaviors in a team context (as rated by themselves, their peers, and their coach) would be rated as more effective, satisfying, and effort-evoking leaders by their peers and coaches. Participants were 112 high school students (mean age = 15.2 years) who were members of 11 sports teams, and their team coaches. Controlling for the effects of adolescents' skills, results obtained using structural equation modeling supported the predicted model. Conceptual and empirical issues regarding the development and effects of transformational leadership in adolescents are discussed.     

Peer Effects in Risk Aversion

We estimate peer effects in risk attitudes in a sample of high school students. Relative risk aversion is elicited from surveys administered at school. Identification of peer effects is based on parents not being able to choose the class within the school of their choice, and on the use of instrumental variables conditional on school‐grade fixed effects. We find a significant and quantitatively large impact of peers’ risk attitudes on a male individual's coefficient of risk aversion. Specifically, a one standard deviation increase in the group's coefficient of risk aversion increases an individual's risk aversion by 43%. Our findings shed light on the origin and stability of risk attitudes and, more generally, on the determinants of economic preferences.     

Adolescents’ and Young Adults’ Online Risk Taking: The Role of Gist and Verbatim Representations

Young people are exposed to and engage in online risky activities, such as disclosing personal information and making unknown friends online. Little research has examined the psychological mechanisms underlying young people's online risk taking. Drawing on fuzzy trace theory, we examined developmental differences in adolescents’ and young adults’ online risk taking and assessed whether differential reliance on gist representations (based on vague, intuitive knowledge) or verbatim representations (based on specific, factual knowledge) could explain online risk taking. One hundred and twenty two adolescents (ages 13–17) and 172 young adults (ages 18–24) were asked about their past online risk‐taking behavior, intentions to engage in future risky online behavior, and gist and verbatim representations. Adolescents had significantly higher intentions to take online risks than young adults. Past risky online behaviors were positively associated with future intentions to take online risks for adolescents and negatively for young adults. Gist representations about risk negatively correlated with intentions to take risks online in both age groups, while verbatim representations positively correlated with online risk intentions, particularly among adolescents. Our results provide novel insights about the underlying mechanisms involved in adolescent and young adults’ online risk taking, suggesting the need to tailor the representation of online risk information to different age groups.     

Workers’ Risk Tolerance and Occupational Injuries

This study explores the relationship between individuals’ risk tolerance and occupational injuries. We analyze data from a national representative survey of U.S. workers that includes information about injuries, risk tolerance, cognitive and noncognitive attributes, and risky behaviors. We measure risk tolerance through questions regarding individuals’ willingness to gamble on their lifetime income. We estimate zero‐inflated count models to assess the role played by such measures on workers’ recurrent injuries. We discuss some implications of our results for future research and occupational safety policies. Our results highlight the concurrent and changing role played by individual, work, and environmental factors in explaining recurrent incidents. They show that risk tolerance affects recurrent injuries, although not in the direction that proponents of the concept of proneness would expect. Our measure of risk aversion shows that individuals who are somewhat more risk tolerant have fewer recurrent injuries than those who are risk averse. But the estimated relationship is U‐shaped, not monotonic and, therefore, not easy to predict. At the same time, we find that individuals’ “revealed risk preferences”—specific risky behaviors—are related to higher injury probabilities. Demanding working conditions, measures of socioeconomic status, health, and safety problems experienced by workers during their youth remain among the most important factors explaining the phenomena of recurrent injuries. So our results contribute also to the important debate about the relationship between health and socioeconomic status.     

Tools to Cope with Clients’ Misbehavior: A Comparative Study

In a comparative study, 56 professionals who work in public organizations: schools, welfare and health agencies, were presented with three vignettes about conflicts with clients. They were then asked how they would respond to each case and which of their actions they would define as tools. It was found that nurses appear to hold the most mature practical and theoretical knowledge of tools; teachers present a rather practical stance, while social workers and school psychologists tend to rely on intuitive and ad hoc solutions. The discussion suggests how to educate professionals to use skills and tools more effectively in response to frequent chaotic situations.     

Understanding Public Perceptions of Benefits and Risks of Childhood Vaccinations in the United States

In the face of a growing public health concern accompanying the reemerging threat of preventable diseases, this research seeks mainly to explain variations in the perceived benefits and risks of vaccinations among the general public in the United States. As Mary Douglas and Aaron Wildavsky's grid‐group cultural theory of risk perception claims, the analytical results based upon original data from a nationwide Internet survey of 1,213 American adults conducted in 2010 suggest that individuals’ cultural predispositions contribute to the formation of their perceptions pertaining to vaccine benefits and risks at both societal and individual levels, in conjunction with other factors suggested by previous risk perception literature, such as perceived prevalence of diseases, trust, knowledge level, and demographic characteristics. Those with a strong hierarch orientation tend to envision greater benefits and lesser risks and conceive of a relatively high ratio of benefit to risk when compared to other cultural types. By contrast, those with a strong fatalist tendency are inclined to emphasize risks and downplay benefits while conceiving of a low vaccination benefit‐risk ratio. Situated between hierarchs and fatalists, strong egalitarians are prone to perceive greater benefits, smaller risks, and a more positive benefit‐risk ratio than strong individualists.     

Challenges in Development and Implementation of Health‐Risk‐Based Soil Quality Guidelines: Turkey's Experience

Management of contaminated sites is a critical environmental issue around the world due to the human health risk involved for many sites and scarcity of funding. Moreover, clean‐up costs of all contaminated sites to their background levels with existing engineering technologies may be financially infeasible and demand extended periods of operation time. Given these constraints, to achieve optimal utilization of available funds and prioritization of contaminated sites that need immediate attention, health‐risk‐based soil quality guidelines should be preferred over the traditional soil quality standards. For these reasons, traditional soil quality standards are being replaced by health‐risk‐based ones in many countries and in Turkey as well. The need for health‐risk‐based guidelines is clear, but developing these guidelines and implementation of them in contaminated site management is not a straightforward process. The goal of this study is to highlight the problems that are encountered at various stages of the development process of risk‐based soil quality guidelines for Turkey and how they are dealt with. Utilization of different definitions and methodologies at different countries, existence of inconsistent risk assessment tools, difficulties in accessing relevant documents and reports, and lack of specific data required for Turkey are among these problems. We believe that Turkey's experience may help other countries that are planning to develop health‐risk‐based guidelines achieve their goals in a more efficient manner.     

Reducing Passive Smoking by Promoting Self Segregation of Smokers Using Signs and Thematic Prompts

Recent research has demonstrated that passive smoking presents a long-term health hazard for nonsmokers and it is often a source of immediate discomfort for them. As a result a high percentage of nonsmokers and some smokers agree that the exposure of nonsmokers to sidestream smoke should be minimized whenever possible. An ABAB reversal design was used to test the effects of the presentation and removal of signs and thematic prompts (ashtrays) that designated a smoking area and a smoke-free area in the main University Union Cafeteria at the University of Otago. The posting of signs and the relocation of ashtrays significantly increased the proportion of the total number of smokers restricting their activity to the designated area. A follow-up observation conducted two weeks after the completion of Intervention 2 showed that this behaviour had been maintained. Although the prompts were effective in moving smokers into the smoking area the overall number of smokers did not differ significantly across conditions.     

Risk Management and the Wisdom of Aldo Leopold

Human demands on nature have increased due to our burgeoning population. The applications of scientific knowledge to the development of increasingly powerful technologies and consumptive lifestyles by more and more people have created a modern category of human‐caused disaster—stealth disasters. Stealth disasters—such as agriculturally‐induced soil erosion and release of unprecedented amounts of greenhouse gases into Earth's atmosphere—tend to have protracted, unobvious onsets; do not necessarily have dramatic manifestations; and often do not attract public attention until they reach a stage approaching catastrophic consequences. At this late stage it is difficult or impossible to undo damage. Scientists tend to be among the first to understand the physical causes and notice the developments of stealth disasters and their risks and yet scientific knowledge is not enough to prevent or mitigate them. As we search for ways to deal with stealth disasters, the concept of “land health” assembled by the prominent conservationist and author, Aldo Leopold (1887–1948), can, in normative terms, provide an ecologically grounded example of nature in good condition toward which society can aim. Evidence of the reverse—symptoms of land illness—can provide a checklist for risk analysis and management that helps guide people away from harm‐causing attitudes and activities and toward beneficial outcomes. Leopold's criteria of land health motivated by a land ethic that incorporates the whole of nature may be applied at geographic scales ranging from local to global as a framework for contemporary risk management.     

A Deliberative Method for Ranking Risks (I): Overview and Test Bed Development

Risk ranking offers a potentially powerful means for gathering public input to help set risk-management priorities. In most rankings conducted to date, the categories and attributes used to describe the risks have varied widely, the materials and procedures have not been designed to facilitate comparisons among risks on all important attributes, and the validity and reproducibility of the resulting rankings have not been assessed. To address these needs, a risk-ranking method was developed in which risk experts define and categorize the risks to be ranked, identify the relevant risk attributes, and characterize the risks in a set of standardized risk summary sheets, which are then used by lay or other groups in structured ranking exercises. To evaluate this method, a test bed involving 22 health and safety risks in a fictitious middle school was created. This article provides an overview of the risk-ranking method and describes the challenges faced in designing the middle school test bed. A companion article in this issue reports on the validity of the ranking procedures and the level of agreement among risk managers regarding ranking of risks and attributes.     

INDIVIDUAL RISK ATTITUDES: MEASUREMENT,DETERMINANTS, AND BEHAVIORAL CONSEQUENCES

This paper studies risk attitudes using a large representative survey and a complementary experiment conducted with a representative subject pool in subjects' homes. Using a question asking people about their willingness to take risks “in general”, we find that gender, age, height, and parental background have an economically significant impact on willingness to take risks. The experiment confirms the behavioral validity of this measure, using paid lottery choices. Turning to other questions about risk attitudes in specific contexts, we find similar results on the determinants of risk attitudes, and also shed light on the deeper question of stability of risk attitudes across contexts. We conduct a horse race of the ability of different measures to explain risky behaviors such as holdings stocks, occupational choice, and smoking. The question about risk taking in general generates the best all‐round predictor of risky behavior.     

Offenders’ Risk‐Taking Attitude Inside and Outside the Prison Walls

It has long been assumed that risk taking is closely associated with criminal behavior. One reason for placing criminals behind bars—aside from punishment and protecting the public—is to prevent them from engaging in further risky criminal activities. Limited attention has been paid to whether being inside or outside prison affects offenders’ risk‐taking behaviors and attitudes. We compared risk‐taking behaviors and attitudes in five risk domains (ethical, financial, health/safety, recreational, social) among 75 incarcerated offenders (i.e., offenders who are currently in prison) and 45 ex‐offenders (i.e., offenders who have just been released from prison). Ex‐offenders reported higher likelihood of engaging in risky behavior, driven largely by a willingness to take more risks in the recreational and ethical domains. Benefits attributed to risk taking as well as risk perception did not differ between incarcerated and ex‐offenders, indicating that the opportunity to take risks might underlie behavioral risk intentions. Our results also indicate that risk‐taking activities are better predicted by the expected benefits rather than by risk perception, aside from the health/safety domain. These results highlight the importance of studying the person and the environment and examining risk taking in a number of content domains.     

Risk Governance for Mobile Phones,Power Lines,and Other EMF Technologies

Power‐frequency electric and magnetic fields (EMFs) have been present in industrialized countries since the late 19th century and a considerable amount of knowledge has been accumulated as to potential health effects. The mainstream scientific view is that even if there is a risk, it is unlikely to be of major public‐health significance. EMFs from cellular communications and other radio‐frequency technologies have increased rapidly in the last decade. This technology is constantly changing, which makes continued research both more urgent and more challenging. While there are no persuasive data suggesting a health risk, research and particularly exposure assessment is still immature. The principal risk‐governance issue with power frequencies is how to respond to weak and uncertain scientific evidence that nonetheless causes public concern. For radio‐frequency electromagnetic fields, the issue is how to respond to large potential consequences and large public concern where only limited scientific evidence exists. We survey these issues and identify deficits in risk governance. Deficits in problem framing include both overstatement and understatement of the scientific evidence and of the consequences of taking protective measures, limited ability to detect early warnings of risk, and attempted reassurance that has sometimes been counterproductive. Other deficits relate to the limited public involvement mechanisms, and flaws in the identification and evaluation of tradeoffs in the selection of appropriate management strategies. We conclude that risk management of EMFs has certainly not been perfect, but for power frequencies it has evolved and now displays many successful features. Lessons from the power‐frequency experience can benefit risk governance of the radio‐frequency EMFs and other emerging technologies.