PhD in Nursing Science Program

Associations between Risk Perception, Smoking Behaviors, and Lung Cancer Screening in Smokers Receiving Inpatient Tobacco Treatment: A Prospective Study

Dissertation under the direction of Professor Shelagh Mulvaney 

Cigarette smokers underestimate health risks associated with developing smoking-related conditions. However, the exploration of perceived risk among hospitalized smokers has been less studied. The purpose of this study was to evaluate change in perceived risk for developing a smoking-related condition and examine the influence of perceived risk, in the context of smoking risk factors, on smoking outcomes. Data were collected from adult, hospitalized smokers, who had been recently exposed to a brief, inpatient tobacco treatment program. Study aims to examine relationships between perceived risk, smoking outcomes, and contextual smoking risk factors were achieved using a non-experimental, single group, quantitative design with a retrospective pretest and a post-test over a six-month study period. A total of 134 hospitalized smokers were enrolled in the study. There was a positive increase in perceived risk scores (0.37) after exposure to inpatient tobacco treatment. Yet, only 23.1% (n= 31) demonstrated a clinically, significant reliable increase in perceived risk (+0.82). Sixty-three participants remained enrolled at three-month follow-up. Perceived risk was completely unrelated across all smoking outcomes. Statistically significant relationships were identified between smoking status with time to first cigarette (OR = 1.02, p=0.038), a self-reported quit attempt with readiness to quit (OR = 2.08, p<.001), and reduced consumption of cigarettes with both time to first cigarette (OR = 1.02, p=0.033) and age (OR = 1.05, p=0.028). Study findings demonstrate how exposure to a brief, inpatient tobacco treatment program can positively impact health risk perception and short-term smoking behaviors. Future investigation is warranted to continue exploration among hospitalized smokers to further elucidate relationships between perceived risk, contextual smoking risk factors, and smoking outcomes.