Do cigarette smokers have unrealistic perceptions of their lung cancer and Chronic Obstructive Pulmonary Disease (COPD) risks? A Cross-sectional study

Background: Cigarette smoking causes serious complications and diseases in a person's life, such as Chronic Obstructive Pulmonary Disease (COPD) and some cancers, including lung cancer. On the other hand, studies have shown that smokers do not have a real understanding of the health hazards of smoking. This study was conducted to determine the perceived risk of lung cancer and COPD in smokers. Methods: This cross-sectional study which was conducted between January-May 2023, recruited 380 smokers by convenience sampling. The data were collected using three questionnaires 1) the risk perception for lung cancer and COPD questionnaire, 2) the smoking stage of change questionnaire, and 3) the Fagerström test for nicotine dependence. We examined the relationship between the included variables and the smokers’ perceived risk of lung cancer and COPD by using multiple linear regression. We performed this analysis with Stata software version 17 and the significance level was set at 0.05. Results: The mean age of participants was 35.57 ± 12.05 years, and 77.1% were male. The perceived risk score of COPD was 10.94±4.88 and the score related to lung cancer was 10.60±4.77. We found that lower education (coefficient=3.86 for elementary and 3.18 for secondary), longer smoking duration (coefficient=-3.22 for 20-29 years and -5.88 for 30+ years), and older smoking age onset (coefficient=-2.41 for 20+ years) were associated with lower perceived risk for both diseases. High social status (coefficient=-4.73) was also associated with a lower perceived risk of lung cancer. Moreover, people who smoked for 20-29 years (coefficient=-2.77, [-4.75, -0.79] 95%CI, P<0.0001) or 30+ years (coefficient=-5.40, [-8.05, -2.75] 95%CI, P<0.0001); had lower perceived risk than those who smoked for less than 10 years. Also, smokers who started smoking at 20+ years old had lower perceived risk than those who started before the age of 20 [coefficient=-1.61, [-2.76, -0.46] 95%CI, P<0.0001]. Conclusion: The results of this study showed that the perceived risk of participants was relatively low. Also, the perceived risk decreases as the duration of smoking increases. It seems necessary to carry out interventions to inform about the harms of smoking and to enhance public awareness about the heightened risks of diseases such as lung cancer and COPD among cigarettes smokers.