The smoking paradox: exploring why attitudes toward cigarette smoking are a weak predictor of cigarette smoking

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Objective An attitude change perspective represents a central line of research in the smoking literature. This line of research focuses on influencing individuals’ attitudes toward smoking in order to alleviate the negative outcomes of smoking and to achieve positive smoking behaviours. This line of research, however, does not explain why attitudes toward cigarette smoking are a weak predictor of cigarette smoking, an indication of a smoking paradox. The current study introduces two domain-general factors to explore this smoking paradox. Design We used an online survey and collected data from American subjects (n = 328) via a crowdsourcing platform, Amazon Mechanical Turk, in 2018. Results We found that the association between attitude toward smoking and the likelihood of smoking is significantly weaker when individuals perceive a low probability of risk and/or believe that this probable risk will only occur in the distant future, after many years. These results suggest that smoking may not be consistent with attitude because individuals perceive low probability of risk and/or they temporally discount the occurrence of this probable risk. Conclusion The results suggest that novel strategies that incorporate the concepts of perceived risk probability and temporal discounting of the probable risk are needed for smoking cessation.