“Smoking is dangerous to my health:” The impact of the perception of health messages on smoking behavior in a southern city

Health messages can be influenced by multiple social cues, and in turn shape attitudes and impact an individual's behavior. The purpose of this study is to examine beliefs about the severity of smoking cigarettes. Data were collected from high school students in a large southeastern city (N=4336). The majority of the students were female (54.7%). African American students constituted 73.9% of the population, while White students comprised 22.9% of the population. Students were asked “How much do you agree with this statement: Smoking is dangerous to my health.” Most students strongly agreed (74.0%) followed by 22.1% who agreed, 2.5% disagreed and 1.4% strongly disagreed with the statement. Responses differed according to: being female (p<0.001), being White (p<0.001), self-identifying as a “nonsmoker” (p<0.001), never smoking cigarettes (p<0.001), having a parent that smokes (p<0.001), home smoking restrictions, (p<0.001), feeling smoking is occasionally harmful (p<0.001), friends smoking behaviors (p<0.001), perceptions about being popular (p<0.001) or looking cool (p<0.001), susceptibility to smoking (p<0.001) and addiction (p<0.001). Interestingly, our study found that even if friends offered them a cigarette, those who felt smoking was dangerous were more likely to respond they would definitely not smoke (p<.001). Therefore, health messages may be important reinforcement tools for family and health practitioners, despite the effects of peer pressure and other modeling behaviors. Determining social exposures and cues that may increase the perceived severity of cigarette smoking is essential to developing appropriate prevention programs and strengthening health messages targeted at the youth population.