The Smoking Puzzle: Information, Risk Perception, and Choice
http://www.100md.com
《新英格兰医药杂志》
Warning: the surgeon general has determined that smoking cigarettes increases the chance that you will need to ask your closest friends and relatives to assist you in bathing, using the bathroom, preparing meals, shopping, and taking care of your most basic necessities during the last months or years of your life.
This warning label does not appear in the scholarly book by Sloan and his coauthors, but if the avenue of research they propose is carried out, something like it may be used in the not-too-distant future. In this book, the authors have taken on the tasks of developing and (much more difficult) quantifying effective strategies to persuade late-middle-aged smokers to quit smoking. Many information campaigns about the dangers of smoking are directed specifically at younger people (for excellent reasons), and one might think that older smokers are hopelessly entrenched and simply immune to basic health messages. The writers have obvious sympathy for the millions of smokers who became addicted before the advent of warning labels on cigarettes — a product that can be excruciatingly difficult to give up.
The authors' stated goal in this book is to "break down the smoking puzzle into its constituent elements — information, risk perception, and smoking behavior." And they achieve this with a modest but authoritative presentation of their own work, combined with examinations of other research on the subject. The discussions and conclusions presented are readily accessible to the lay professional, but the detailed analysis of methods and results might best be appreciated by epidemiologists, economists, and others familiar with statistical analysis.
The results of focus-group studies carried out by the authors, like many great discoveries, are almost obvious. The most effective deterrents to smoking for people who have been addicted for decades are highly personalized: for instance, the advent of a major smoking-related illness to the smoker or a close family member. Since many smokers may reason (not illogically) "We all have to go some-time . . .," health messages that stress the possible loss of a few years of life are simply not as effective as bringing home the realization that the end of life may not come quickly and painlessly but might well entail considerable helplessness and disability, a dread to which we can all relate. I was delighted with the authors' suggestions for further research, which included the idea that information campaigns that emphasize quitting might also give advice on how to avoid gaining weight in the process. That message is scholarly common sense at its best.
The authors suggest, and I agree, that with so many lives at stake, much more must be done to translate disease risks to personal action and tailor messages to fit the needs of any given population subgroup.
Luis G. Escobedo, M.D., M.P.H.
New Mexico Department of Health
Las Cruces, NM 88001
lescobedo@hrsa.gov(By Frank A. Sloan, V. Ker)
This warning label does not appear in the scholarly book by Sloan and his coauthors, but if the avenue of research they propose is carried out, something like it may be used in the not-too-distant future. In this book, the authors have taken on the tasks of developing and (much more difficult) quantifying effective strategies to persuade late-middle-aged smokers to quit smoking. Many information campaigns about the dangers of smoking are directed specifically at younger people (for excellent reasons), and one might think that older smokers are hopelessly entrenched and simply immune to basic health messages. The writers have obvious sympathy for the millions of smokers who became addicted before the advent of warning labels on cigarettes — a product that can be excruciatingly difficult to give up.
The authors' stated goal in this book is to "break down the smoking puzzle into its constituent elements — information, risk perception, and smoking behavior." And they achieve this with a modest but authoritative presentation of their own work, combined with examinations of other research on the subject. The discussions and conclusions presented are readily accessible to the lay professional, but the detailed analysis of methods and results might best be appreciated by epidemiologists, economists, and others familiar with statistical analysis.
The results of focus-group studies carried out by the authors, like many great discoveries, are almost obvious. The most effective deterrents to smoking for people who have been addicted for decades are highly personalized: for instance, the advent of a major smoking-related illness to the smoker or a close family member. Since many smokers may reason (not illogically) "We all have to go some-time . . .," health messages that stress the possible loss of a few years of life are simply not as effective as bringing home the realization that the end of life may not come quickly and painlessly but might well entail considerable helplessness and disability, a dread to which we can all relate. I was delighted with the authors' suggestions for further research, which included the idea that information campaigns that emphasize quitting might also give advice on how to avoid gaining weight in the process. That message is scholarly common sense at its best.
The authors suggest, and I agree, that with so many lives at stake, much more must be done to translate disease risks to personal action and tailor messages to fit the needs of any given population subgroup.
Luis G. Escobedo, M.D., M.P.H.
New Mexico Department of Health
Las Cruces, NM 88001
lescobedo@hrsa.gov(By Frank A. Sloan, V. Ker)