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Biased Lung Cancer Risk Perceptions: Smokers are Misinformed

Nicolas R. Ziebarth


This paper empirically investigates biased beliefs about the risks of smoking. First, it confirms the established tendency of people to overestimate the lifetime risk of a smoker to contract lung cancer. In this paper’s survey, almost half of all respondents overestimate this risk. However, 80% underestimate lung cancer deadliness. In reality, less than one in five patients survive five years after a lung cancer diagnosis. Due to the broad underestimation of the lung cancer deadliness, the lifetime risk of a smoker to die of lung cancer is underestimated by almost half of all respondents. Smokers who do not plan to quit are significantly more likely to underestimate this overall mortality risk.

JEL Classification: D81; D84; I12; L66


I thank the editors Hendrik Juerges and Joachim Winter, anonymous referees, Don Kenkel, Jing Li, Dean Lillard, Petter Lundborg, Jeff Niederdeppe, Kip Viscusi, Gert G. Wagner and participants at the 2016 EuHEA conference in Hamburg for very helpful comments and suggestions. I also thank Beining Niu and Kaylin Yu for copyediting this paper. I take responsibility for all remaining errors in and shortcomings of the article. Generous support from the Deutsche Forschungsgemeinschaft (DFG; “German Science Foundation”, WA 547/5-1) and the Open Research Area in Europe for the Social Sciences (ORA-10-36) is gratefully acknowledged. The research reported in this paper is not the result of a for-pay consulting relationship. Cornell does not have a financial interest in the topic of the paper which might constitute a conflict of interest.

Article note

This article is part of the special issue “Empirical Health Economics” published in the Journal of Economics and Statistics. Access to further articles of this special issue can be obtained at


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Appendix. Descriptive statistics

MeanStd. Dev.Min.Max.N
A. Perceived Cancer Risks
Smoker Lifetime Lung Cancer Risk31.050526.385811001860
Overestimation Lung Cancer Risk0.43610.4962011860
Underestimation Lung Cancer Risk0.24240.4287011860
5-Year Lung Cancer Survival Rate4.54782.18471101860
Overestimation Survival0.80110.3993011860
Calculated Smoker Total Mortality Risk0.18880.18750.050.951860
Overestimation Total Mortality Risk0.45270.4979011860
Underestimation Total Mortality Risk0.23060.4214011860
B. Smoking information
Never Smoker0.37690.4847011860
Ex Smoker0.26770.4429011860
#Cigarettes Smoked Yesterday5.23018.86370601860
Heavy Smoker (>15 cigarettes)0.19780.3984011860
Don’t Plan to Quit0.07790.2682011860
Plan to Quit0.16560.3718011860
Unlikely to Quit0.14030.3474011860
C. Other health behavior
Daily Exercise0.18230.3862011860
No Sports0.26290.4403011860
#Drinks Yesterday0.89462.03320271860
D. Risk aversion and discount rates
Risk Tolerance5.01452.15960101860
Risk Averse0.36450.4814011860
Risk Loving0.27150.4448011860
Discount Rate min. 10 %0.22740.4193011860
Discount Rate min. 20 %0.21020.4046011860
Discount Rate min. 30 %0.18600.3892011860
Discount Rate>10 %0.62370.4846011860
C. Socio-demographics
Annual Gross Household Income6.44352.88711111860
#HH Members (11 categories)2.14351.07711131860
Full-Time Employed0.47470.4995011860
8 Years of Schooling0.07900.2699011860
Master‘s Degree0.32740.4693011860
Life Satisfaction6.64841.98540101860
Received: 2016-10-31
Revised: 2018-01-30
Accepted: 2018-02-25
Published Online: 2018-07-03
Published in Print: 2018-09-25

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