A series of surveys since 1983 have investigated smokers' (and others') beliefs about the effects of smoking. A cross-section of these findings are presented in Table 3.5 below.
The first data set, collected as part of the national prevalence survey undertaken by Hill and Gray,(169) showed that around one-quarter of the smoking population did not believe that smoking caused illness in 1983. While subsequent Victorian surveys have shown an encouraging downturn in this trend.(170,171,172) it still appears that in 1991 around one in seven smokers attributed no illness at all to smoking (compared to never-smokers and past smokers, of whom only 3% and 5% respectively shared this view). However it is likely that smokers' stated beliefs reflect at least some degree of denial.
For the most part, awareness of particular illnesses has increased or remained steady. An apparent fluctuation in awareness of lung cancer between 1983 and 1991 cannot be readily explained, except that it is offset by an overall increase in awareness of cancer in general for all but the most recent survey year. Emphysema, the subject of a television advertisement produced by the Victorian Smoking and Health Program, has become far more commonly identified by smokers.
While it is likely that smokers' awareness of the health consequences of smoking has increased nationally since the first survey in 1983, care should be taken in applying the Victorian data provided below to other states. Awareness is likely to be a result of media and other health education campaigns, which differ between states in emphasis, targeting, style, size and funding (see Chapter 13).
Health warnings on tobacco packages (see Chapter 5, Section 6), school-based education programs and media coverage of smoking issues are also likely to influence awareness levels in the general population. Surveys by the National Campaign Against Drug Abuse have shown an increase in community awareness of tobacco as a drug problem, as well as increased identification by smokers of tobacco as their top personal drug concern.(173)
Note: Similar survey questions have been asked as part of the evaluation of the 1989 campaign of the South Australian Smoking and Health Project.(174) However in South Australia the responses were prompted, unlike the surveys reported above, and so are not directly comparable.
A national study on cancer related beliefs and behaviours in Australia undertaken in 1988 showed that 'not smoking' was the measure to prevent cancer most frequently mentioned by all population sub groups. Equal proportions (58%) of smokers and non-smokers nominated not smoking, and males, younger age groups and those with a higher attained level of education mentioned smoking more often.(175)
There is evidence that while smokers may accept the general proposition that smoking is harmful to health, they may at the same time dismiss their own chances of being affected. This may reduce their intention to quit. Australian research has shown that smokers are also more inclined than ex-smokers to support a range of self-exempting or cognitive dissonance reducing beliefs about smoking.(176) See Chapter 12, Section 3 for further discussion.