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also found a positive relationship between perceived smoking benefits and nonsmokers’ likelihood of smoking, whereas the cons of smoking were less predictive of smoking (Pallonen et al. 1998). Researchers have also noted that adolescent smokers tend to perceive that benefits are more likely to occur and that risks are less likely to occur compared with adolescents who have not smoked (Goldberg et al. 2002; Halpern-Felsher et al. 2004).

Summary

In summary, research suggests that adolescents misperceive the magnitude of smoking harms and the addictive properties of tobacco and fail to appreciate the long-term dangers of smoking, especially when they apply the dangers to their own behavior. When taken together with the general tendencies of adolescents to take a short-term perspective and to given substantial weight to peer influences, they tend to unduly discount the risks and overstate the benefits of smoking. These distorted risk perceptions are associated with adolescents’ decisions to initiate tobacco use, a decision that they will later regret.

ATYPICAL PATTERNS OF TOBACCO USE

The discussion has thus far focused on what may be regarded as the “standard” pattern of tobacco use. The typical case of tobacco addiction involves a person who began smoking as a teenager; rapidly escalated to daily use and to nicotine addiction; and eventually has a “smoking career” of 15 to 20 years of frequent daily use, characterized by heavy regret and punctuated by unsuccessful efforts to quit. In this section, the committee calls attention to patterns of smoking that deviate from this typical pattern (e.g., an increase in occasional, and perhaps non-addictive or less addictive, smoking to highlight the challenges that they pose for tobacco use prevention and control efforts).

One pattern of occasional smoking is nondaily smoking. Most smokers smoke cigarettes every day. Nondaily smoking was once thought to occur only in the first few years of initiation, before the development of nicotine dependence. However, research conducted since 1990 suggests that occasional smoking is becoming more frequent among U.S. smokers, whereas daily smoking is declining. A survey of 32 Minnesota work sites conducted from 1987 to 1990 found that 18.3 percent of smokers were nondaily smokers (Hennrikus et al. 1996). At follow-up two years later, 21.5 percent were nondaily smokers, suggesting that the rate of occasional smoking was increasing. Results from the Behavior Risk Factor Surveillance Survey (BRFSS) showed that the median proportion of “some-day” smokers among adults aged 18 years and older increased from 17.2 percent in 1996



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