Exploring Interrelationships Among Numeracy, Cancer Risk Perceptions, and Tobacco Product Use

Objective Modified risk tobacco products are emerging that potentially reduce risk or exposure to harmful chemicals compared to cigarettes. Strategies to communicate the risk of using these products can include using quantitative information. Numeracy, the ability to understand and work with numbers, can impact the how people consume and act upon this information. There is a paucity of information on how numeracy affects perceived risks of and tobacco product use. Methods In 2023, participants 18 or older (N = 1072), were recruited from a commercial survey panel and completed an online questionnaire that assessed numeracy-related variables, tobacco use, and experiential, affective, and deliberative aspects of perceived cancer risk. Mediation and logistic regression models were conducted to examine the interrelationships between numeracy, risk perception, and tobacco use. Results The relation between numeracy and tobacco use was mediated by experiential, affective, and deliberative aspects of cancer risk (eg, increasing preference in numbers when being told the chance of something happening was associated with lower deliberative and higher affective/experiential risk perceptions, which translated into lower (for deliberative) and higher (for experiential) likelihood of no past 30-day cigarette use (ab = 0.014, P = 0.005)). The association between numeracy and risk perception differed by tobacco use status. Conclusion Results suggest that numeracy-related variables, and specifically individuals’ preferences in how they obtain risk information, are associated with risk perception which in turn is associated with tobacco use. These findings provide evidence to inform the development of educational programs designed to incorporate different numeracy levels that target specific constructs of risk perceptions associated with tobacco use.