Prototype Perception among Children

In a study of Danish and American adolescents (ages 13-15 years) we examined prevalence estimates and prototype perceptions related to health risk behaviors (Gibbons, Helweg-Larsen, & Gerrard, 1995). We found that Americans were more likely than Danes to self-enhance. Furthermore, Americans overestimated the prevalence of the various risk behaviors (among their peers) more so than Danes and those estimates were more closely linked to their own risk behaviors for the American sample. Perceptions of prototypes associated with a particular risk behaviors were assessed and predicted smoking behavior and willingness to engage in unprotected sexual intercourse for both samples.

Acculturation and Smoking Risk Perceptions

Little research has focused on acculturation and perceptions of health-related risks. In this study (Helweg-Larsen & Stancioff, 2008) we investigated acculturation and risk perceptions of heart attack and lung cancer among a group of refugees. Questionnaires were distributed to a sample of Bosnian refugees living in the United States (N=55). Results indicated that smokers thought they were less at risk than other smokers and no more at risk than non-smokers, whereas non-smokers did not think they were less at risk than other non-smokers. Greater acculturation was associated with greater perception of smokers’ risk of heart attack and lung cancer. Smoking cessation interventions with refugees should incorporate culturally appropriate risk information.

Risk Perceptions among Danish and U.S. Young Adults

In this paper, we examined risk perceptions of lung cancer among smokers and non-smokers in a smoking-lenient (Denmark) and a smoking-prohibitive (the United States) culture (Helweg-Larsen & Nielsen, 2008). Results revealed cross-cultural differences suggesting that Danish smokers showed greater risk minimization than U.S. smokers. In addition, in both countries the risk of a typical smoker was rated as lower by smokers than non-smokers and smokers rated their personal risk as lower than they rated the risk of the typical smoker. Cross-cultural differences in moralization of smoking might be one explanation for these findings.

Risk Perception and Moralization among Danish and U.S. Smokers

In this research we explored role that culture plays in smokers’ description of their risk perceptions and experiences as targets of moralization (Helweg-Larsen, Tobias, and Cerban, 2010). We conducted in-depth qualitative interviews with 15 smokers each from Denmark (a smoking-lenient culture) and the USA (a smoking-prohibitive culture). Smokers said they were well aware of the risks of smoking yet minimized the risks of active and passive smoking; Danes were particularly likely to minimize these risks. Smokers also described many experiences as targets of moralization and accepted some elements of moralized attitudes although overall Danes more strongly rejected moralized opinions. This research points to the importance of considering cultural influences on moralization and risk perception of smoking.

In a second study on the relationship between moralization, perceived risk, and smoking cessation representative samples of smokers in Denmark (a smoking lenient country; N = 429) and the United States (a smoking prohibitive country; N= 431) completed surveys 6 months apart. As expected, Danish smokers (compared to U.S. smokers) moralized less and estimated that their personal risk of lung cancer was smaller. Furthermore, moralization at T1 predicted an increase in perceived personal risk at T2 (for Danish and marginally for U.S. smokers), a decrease in smoking behaviors (for Danish smokers only), and an increase in quitting intentions (marginally for Danish smokers only). For Danish smokers, perceived personal risk mediated the relationship between moralization and quitting intentions. Moralization predicted an increase in perceived personal risk, an increase in quitting intentions, and a reduction in smoking behaviors especially for the Danish sample.