Moralization, Risk Perceptions, and Smoking Cessation in the U.S. and Denmark

描述（由申请人提供）：吸烟者是否真正意识到吸烟所带来的健康风险？这个问题的答案对健康教育项目、戒烟项目、公共卫生政策以及针对烟草公司的法律诉讼有着深远的影响。研究表明，美国成年吸烟者认为他们个人有患吸烟相关疾病（如肺癌）的风险，他们更有可能努力戒烟。然而，我们对人们如何相信他们个人处于危险之中以及文化信息在其中扮演的角色知之甚少。一个重要的文化因素是道德化，这是将偏好转化为价值观的个人和文化过程。研究表明，在美国，吸烟已成为一种被视为道德行为的行为（吸烟被视为本质上不好），而不是一种个人选择。道德化可能会产生大量关于吸烟危害的文化信息，这反过来可能会增加人们对吸烟有多危险的认识（对吸烟者和其他人都有危险）。因此，道德化和风险认知都可能反过来影响戒烟。道德化的影响可以通过比较在这方面不同的文化来最好地研究，比如美国（一个禁止吸烟的文化，吸烟是道德化的）和丹麦（一个吸烟宽松的文化，吸烟的道德化程度要低得多）。在拟议的研究中，美国和丹麦的两项研究将检验道德说教、风险认知和戒烟之间的联系。研究1是一项对美国和丹麦吸烟者进行的定性访谈研究，将调查吸烟者对道德化目标的感知（包括污名化和社会不赞成的感觉）是否与吸烟风险感知（对自己和他人的风险）和减少风险行为（如戒烟、限制或减少吸烟）有关（具体目标1）。研究2是一项对美国和丹麦吸烟者和非吸烟者进行的纵向调查研究，将研究个人道德化在多大程度上预测吸烟风险感知（对自己和他人的风险）（具体目标2），并将研究吸烟者中的这些因素如何预测6个月后戒烟、限制或减少吸烟等降低风险的行为（具体目标3）。了解风险信息和戒烟的文化起源在美国尤其重要，因为美国有大量不同的移民和难民人口。这项研究将为更有效的戒烟计划奠定基础，从而有助于实现2010年健康人的目标，即将美国成人吸烟率降低到12%。公共卫生相关性：本研究将为文化、风险认知和戒烟之间的关系提供有价值的见解，从而为更有效的教育干预和戒烟计划奠定基础。了解风险信息和戒烟的文化起源在美国尤其重要，因为美国有大量不同的移民和难民人口。这项研究将有助于实现2010年健康人的目标，即将美国成人吸烟率从2006年的21%降低到12%。

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%.