Perception of the risks of smoking in the general population and among general practitioners in Ireland

Background. Data on perception of smoking risk amongst the Irish population are sparse. Aims. To study the accuracy and determinants of the perceived risk of premature death due to smoking in the general population and amongst general practitioners (GPs). Methods. Telephone surveys of a representative sample of Irish adults (1,247) and GPs (171; 85% response rate) asked participants to estimate how many of 1,000 20-year-old life-long smokers would die from smoking-related disease before the age of 70 and to identify the main cause of death from a list of seven causes: smoking, road traffic accidents, accidents at work, AIDS, homicide, illicit drugs and alcohol misuse. Results. In the population and GP samples, perception of the risk of smoking-related death was similar (median 200 and 150 deaths per 1,000 smokers respectively, epidemiological estimates 250/1000). Only 43% of the population identified smoking as the most important cause of death compared with 87% of GPs. Current smoking status, younger age, female gender, lower educational attainment and lower income were associated with failure to identify smoking as the main cause of death. Conclusion. Despite decades of health promotion, the general public underestimates the relative importance of smoking as a cause of death.