Smokers underestimate risks of a few cigarettes

The results demonstrate powerfully that the war against smoking is far from over, says oncologist Dr Laurent Greillier from Hopital Nord in Marseille, France, who presented the results at the conference.

Greillier and colleagues analysed data from a representative survey of 1602 French people aged between 40 and 75 years. This 'Edifice' survey included 1463 people with no history of cancer, of whom 481 were former smokers and 330 were current smokers, with an average daily consumption of 14.2 cigarettes.

"Nowadays everyone knows that smoking is a risk factor for developing several cancers, especially lung cancer," Greillier explained. "In this new survey we hypothesized that the perception of the risk of developing this disease could be influenced by personal smoking history. In other words, we thought that the risk might be minimized in smokers compared with never-smokers."

Among the whole sample population, 34% wrongly considered that a daily consumption of up to 10 cigarettes was not associated with any risk of lung cancer, Greillier reported. "This finding is particularly impressive and threatening. It shows that relatively low cigarette consumption is considered as 'safe' for a lot of people. In our study, only half of subjects answered that there is no 'safe' cigarette."

Only half of current smokers considered themselves at higher risk of lung cancer than the average-risk population, and less than 40% of individuals were aware that the risk of lung cancer never disappears after smoking cessation.

"It seems that people are aware about the dangers of tobacco for health, but might consider that the risks are not for themselves, but only for other people," Greillier said.

"It is essential that public health policies continue to focus on the tobacco pandemic. Our findings suggest to urgently initiating campaigns concerning the risk of any cigarette. The war against tobacco is not over!"

Commenting on the study, Dr Carolyn Dresler, a US-based Board Member of the International Association for the Study of Lung Cancer (IASLC), said that the results reflect a common situation internationally.

"People who smoke very much tend to underestimate their risks," Dresler said, "and it makes me think that 'denial' is still prevalent. As an oncologist and tobacco control advocate, it amazes me and strikes me as so unfortunate that such lack of knowledge is so prevalent."

"The risk for lung cancer is most dependent on duration of smoking, but of course the number per day matters also," Dresler said. "The risk for cardiovascular disease starts with that one cigarette per day. So, this survey demonstrates that MUCH education is still required."

"It is very important to make sure that accurate information about the actual risks of tobacco use, particularly for those who continue to smoke, is disseminated," Dresler concluded. "We all have a strong 'denial gene' in us, and education must be clear, relevant and repeated if we are to change the perceptions that are evident from this survey."