The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68513

Vallerie H Propper, BS, John F P Bridges, PhD, and Scott F Grey, MS. Health Services Research, Case Western Reserve University, 10900 Euclid Av., Cleveland, OH 44106-4945, 216-368-6962, vpropper@msn.com

Many public health campaigns are based on behavior modification through education programs. This is particularly the case in context of tobacco control policies that emphasize the negative consequences of smoking. As a consequence of these negative campaigns many individuals overestimate the harmful effects of active smoking, while despite the campaigns many other individuals still underestimate the effects of smoking. This demonstrates that there is great variation in beliefs across the community. Furthermore, such education campaigns are built upon the premise that the beliefs of individuals are modifiable. This paper discusses the two important theoretical literatures concerning modifiable beliefs. First, the Transtheoretical Model (Stages of Change Model), which is a hybrid of a number of theories from the psychotherapy and behavior change literatures, is discussed. This theory relies heavily on the individual’s subjective beliefs and perceptions in order to advance in the stages toward behavior change. Second, the theory of rational addiction, an economic theory based on the model of human capital, allows for endogenous preferences in as far as it allows for the level of addictiveness to be chosen rationally. This model has been further modified to allow for learning, regret and endogenous time preference, both of which have additional effects on beliefs. Both of these models have very important implications for tobacco control policies. Public health practitioners have to be aware the possible variation of beliefs in the community and thus tailor programs specifically. The ethics of variation in, and the changing of, individuals’ beliefs are discussed.

Learning Objectives:

• Participants will become familiar with the Transtheoretical and rational addictions models, be able to identify the importance of these models in the context of modifiable beliefs of the harms of smoking in the community. They will also become aware of the importance of taking into account variation in beliefs when designing and implementing tobacco control policies.

Keywords: Economic Analysis, Tobacco Policy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.