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The Smoking Puzzle

The Smoking Puzzle

Information, Risk Perception, and Choice

Frank A. Sloan, V. Kerry Smith, Donald H. Taylor, Jr.

ISBN 9780674010390

Publication date: 06/15/2003

How do smokers evaluate evidence that smoking harms health? Some evidence suggests that smokers overestimate health risks from smoking. This book challenges this conclusion. The authors find that smokers tend to be overly optimistic about their longevity and future health if they quit later in life.

Older adults' decisions to quit smoking require personal experience with the serious health impacts associated with smoking. Smokers over fifty revise their risk perceptions only after experiencing a major health shock--such as a heart attack. But less serious symptoms, such as shortness of breath, do not cause changes in perceptions. Waiting for such a jolt to occur is imprudent.

The authors show that well-crafted messages about how smoking affects quality of life can greatly affect current perceptions of smoking risks. If smokers are informed of long-term consequences of a disease, and if they are told that quitting can indeed come too late, they are able to evaluate the risks of smoking more accurately, and act accordingly.


  • This book makes an important contribution to tobacco policy by suggesting a new direction in information policy. In doing so, it skillfully navigates between those who claim that smokers rationally understand what they are doing—and in fact may overestimate the health risks they run—and those who claim excise taxes should be increased to keep smokers from harming themselves.

    —Joseph Newhouse, Harvard University


  • Frank A. Sloan is J. Alexander McMahon Professor of Health Policy and Management and Professor of Economics, Duke University.
  • V. Kerry Smith is University Distinguished Professor in the Department of Agricultural and Resource Economics, North Carolina State University.
  • Donald H. Taylor Jr. is Assistant Research Professor, Sanford Institute of Public Policy, Duke University.

Book Details

  • 288 pages
  • 6-1/8 x 9-1/4 inches
  • Harvard University Press