Abstract

While risk perceptions affect various health behaviors, there is insufficient knowledge about how they are formed and change over time surrounding illicit substance use. This study investigates the role of prior use, social influences, and media information on changes in the risk perceptions of expected susceptibility and severity of side effects in the context of the nonmedical use of prescription drugs for cognitive enhancement. It also examines differential updating by testing for the potential conditioning effects of prior use and self-control. We use a three-wave panel design (N = 8,377) with a nationwide random sample of adults in Germany. Fixed-effect regression models show that prior use and positive media information lower both risk perceptions, while negative information from others and the media produce increases. Rare users compared to non- and frequent users were more sensitive to new information obtained through others, thus showing stronger changes in risk perceptions. Moreover, self-control partially moderated the magnitude of changes in both risk perceptions, for example, regarding side effects reported in the media, which affected individuals with low self-control more strongly. In sum, the results indicate that personal and vicarious information affect the updating of risk perceptions, while partial evidence exists for differential updating.

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