Little is known about how cancer diagnosis and tobacco-related risk perceptions are associated with smoking behavior.


We used data from Waves (W) 1–3 (2013–2016) of the Population Assessment of Tobacco and Health Study to analyze longitudinal smoking behavior among adults who were current smokers and not previously diagnosed with cancer at baseline (W1; N = 7,829). The outcome was smoking cessation as of follow-up (W3). Explanatory variables were sociodemographics, other tobacco product use, adult at first cigarette, tobacco dependence, cancer diagnosis after baseline, and tobacco-related risk perceptions [cigarette harm perception, worry that tobacco products will damage one's health (“worry”), belief that smoking causes cancer (“belief”), and nondaily smoking harm perception].


Cessation was significantly associated with baseline worry (OR = 1.26; 95% confidence interval, 1.13–1.40), follow-up cigarette harm perception [OR = 2.01 (1.77–2.29)], and follow-up belief [OR = 1.40 (1.20–1.63)]. Cessation was inversely associated with follow-up (W3) worry, and this association was stronger among those without a cancer diagnosis (OR = 0.37 without cancer; OR = 0.76 among individuals diagnosed with cancer; interaction P = 0.001).


Cessation is associated with tobacco-related risk perceptions, with different perceptions contributing in unique ways. Cessation is predicted by baseline worry but is inversely associated with worry at follow-up, suggesting that perhaps cessation has alleviated worry. The latter finding was stronger among respondents not diagnosed with cancer.


Associations between cancer diagnosis, tobacco-related risk perceptions, and smoking behavior may inform the development of evidence-based smoking cessation interventions.

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