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PROGRESbREPORT -NO. 2: JULY 1-5y ?i962 -:to APRIL '-1 S 1964 ,SQCiOLOGiCAL. AND. PSYCHOLOGFGAI. CORRELATES OF ADOP.TZUN'- "`. AND D]CS.CONT7CNUATION OF CIGARETTE__SMOKING A Report ~ to Tlie -Couiinci 1=For Tobacco Research UoS oA o $ruce C. Straits Uradiar - the cti.rectaon of p. Professar-s , Elaliu Katz and Robert: L. Craiii_ -- -Departme_nt af -Sociotogy University-of Ctiie4g® Jul:Y9 1965

PREFACE This report describes an investigation carried out under grant #354 from the Council For Tobacco Research U.S.A., and covering the period from July 15, 1962 to April 1, 1964. Project Directors: Elihu Katz, Ph.D., Associate Professor of Sociology, University of Chicago Robert L. Crain, Ph.D., Assistant Professor of Sociology, University of Chicago Consultant: Jacob Feldman, Director of Research, National Opinion ResearCii Center, Chicago, Illinois Research Associate: Bruce C. Straits, Graduate Student, Department of Sociology, University of Chicago. The writer wishes to express his appreciation to Professors Robert L. Crain and Elihu Katz who,patiently read the rough drafts of this paper and made helpful suggestions. The research design evolved from ideas outlined'i-n a research proposal by Professor Katz and Mr. Jacob Feldman, and financial support came from the Council for Tobacco Research. I wish especially to thank Professors Crain and Katz for their sympathetic counsel and helpful encouragep ment. ii

TABLE OF CONTENTS Page .-PREFACE. . . . . . « « o . « « ... « . ° . « ° « « « .. 4 « . « « . . . . LIST OF TABLES° .. . . A . . . . . . . • , « . .° « « « « , . « « « « Chap ter . INTRODUCTION AND SPECIFIC AIMS ° . « « « p « « « « « . « « « The Development of the Smoking<Health Controversy ... Why the Study Was Ynitiated « « . ., « ° « ° « « « « How the Data Were Collected ..< . « « p ..« .> « « o « II. INTERPERSONAL ENVIRONMENTS AND SMOKING BEHAVIOR « « Introduction . « . ... . . . , p « « a Data: Adoption of Smoking . . . «c« Parental Influence Influences. Outside-the: Parental Home Attitude. Formation « « « « ° . « « « .. « « « Data: Perceived Balance . . . . « « ° « . ... . . . . . '.Reported Smoking Behavior of Closest « ° « « . « « n « , « « , ° « « « Associates Interpersonal Dissonance Reduction . . . . . . Data: Actual Balance « « « « > . ° o « « « « ° « « « Smoking Behavior Reported by Closest Associates « « , « . . . . « Perceptual Distorti.on « « « « . . « « « « « « ° Similarity in,Other Behavior Related to Smoking .... Conclusion III. THE DISCONTINUATION PROCESS- . . . . . o a o « « « « a « « « ii 1 6 8 9 9 14 16 17 17 21 23 23 27 30 33 35 Framework £or D.iscussisin « « « ° . « « « « . . « . o « 35 Smoking Patterns « ° .«, « « « . ° . a « « ° . « « « p « 37 The Decision-Making Process . . . . . 40 Perceived State of Nature . . . 40 Percei ved Uti T x ty -° -° -- -- -- -- -- -- -- ~ _ -. -. « - 48 Perceived Probability . . . . . 50 Discontinuation-Patterns . . . . « o . « « « p a « « « 53 Discussion « . . ° « « 4 ° . . « . ° « « . « . «. « d « « 58 Conclusion a b o p q . « « « . . . , a . . . . . . . « 64 iii

..Table of Contents (Cont'd.) Chapter Page IV. THE PURSUIT OF THE DISSONANT SiAa1:ER. . . . . . « « , « « « . 67 Introduction . . . . . . • . . . _ • . . « . « • . . a a . 67 A Primer of Dissonance Theory . a..«• a..o « e.a « 68 Dis(.`ussion . o .. • e o o . o o e o 0 o a o, a . o 0 0 72 Conclusion . a. o. a.. a« . G . • . ' a a THEORETICAL ISSUES V « a 73 75 . Introduction : . . . 4 . . . . . . • • • •. a a a a a . a 75 Four Motivational Factors . . . o . , . . . . • . « • « 75 Arousal Seeking ... a. a 0,4 a a a a, o a a 76 Tension.Reduction . . . a 79 Affiliation" .. . o. a 9 a. a a a.. a a, a i nance Do 81 83 m Discussion .,. o o a o o a o 0 0+ o o a o o« o a o 0 84 I7ynami c Aspects a a, a. a a a a. a. a p... a a a New Evi dence 88 90 Arousal Seeking . . . . . 010 . . a a . « « . 90 Tension Reduction . . . . . a . e . • • « Affiliation . . • « « • . . « • . « . . . . • • . a 90 91 Domi nance . . . . . . , a e . . e . . . . . . . . 91 Summary . ..- : . . . 0 . 0 0 . o 0 • 0 0 0 0 0 0 -91 The Genotypi c Approach . « « « . . • . « a . « « « a a « 92 ConcZu,sion . . . . .. . • « o . • e . o . 1 « • . . . a . 95 VI. StTMMARY AND IMPLICATIONS FOR FURTHER RESEARCH .... a.«, . 97 Introduction..a .. o.. o a, o o a o o e e« v« o a« 97 A Word o.f Caution . . . • . o . . . . . . « • • 97 Profile of a ";Quitter'i « . 98 Profile of an "Unable" ... a a... p a.. a. a a a a 100 Current Smokers . . • . . . . . . . . . . a . . . . • • 101 ST1]oking . . . . . a . « . . « . « . « Adoption of « • « 102 , Implications for Further Research . . . . . . . . . a . 104 APPENDIX A. THE THREE-STEP RESEARCH DESIGN . . . . a . . . . . . . . . . 107.' The Screening Survey . . . . a . . a . a . . a . . a . . 107 The Personal Interview . . . . . . . a , . . a . . . . a 110 The Snowball Interview a . . a . . • . a . . . « . . « . 114 Data. Processing . . . . a . . , . . . o , . . . • p . a . 115 B. INTERPERSONAL INFLUENCE AND BALANCE: THEORETICAL REVIEW ««« 117 An Overview of Interpersonal Influence Theory « a««« 117 The Role of Cognitive Inconsistency . . . . . . 0 a . 0 118

V Table of Contents (Cont'd.) APPENDIX B.(Corit'd.) Interpersonal Dissonance Reduction . . . 4 . . . .. . o Introduction to Balance Theory o . . o o . . . . . . . Theoretical Recapitulation . . . . . . . . . . o . . . C. INDIVIDUAL DECISION-MAKINGE THEORETICAL REVIEW .- .>... The Three Subjective Variables . . . . . . . . . . q q Dynami c Aspects of the Model . b.. o.:.... o. D. ON THE USE OF STATISTICAL TLSTS OF- SIGNIFICANCE ....... E. INTERVIEW ;CHEuUirES .~ o a'a a a a u e u u a a a e a e a 9 BIBLIOGRAPHY . . . . . ._< . . p e o 0 o a o o a > o ao a o a o 0 0 0 Page 122 122 127 130 130 133 138 141 157

LIST OF TABLES Table Parental Smoking Behavior . ... . . . . . . . P Page , ` . 10 2. Percentageof Current Regular Cigarette Smokers by Parental Smoking Habits, High School Boys o.... . Q... 11 3. Index of the Imp.act of Parental Smoking,Habits .. Q ... 13 4o Parental Smoking Behavior, College Students ..... 9... 14 5. Attitude Toward Smoking by Parental Smoking Behavior, Smokers b o . . . . . ~ . . . . .. . . . . . . . . . 16 Attitude Toward Smoking by Parental Smoking Behavior, Nonsmokers . . . . . . . . . . . • . . • . ~ • P 17 7. Percentage of Current Smokers Among Respondent's Closest Associates (Reported by Respondent) ... p., o> a. 18 8. zndices of Interpersonal Environments ..... q.. 9.'Belief of Smoker®Cancer Relationship by Number of People Talked With About This Question ..... .... 10. Proportion of,Respondents Who Discussed Smoking . . ... . . q 20 21 and Lung Cancer with Closest Associates 9. 4.•..••••. 23 11. Smoking Behavior Report®d by Closest Associates . o. a. o. 25 12. Description of Closest Relative's Smoking Behavior as Given by Both_Respondent and Relative Expressed as Deviations from Chance Expectancy . . . P . . 4 . . . . . . 26 13. Comparison of Respondent's Description of Associate's - Smoking Behavior with Behavior Reported by Associate ..... 28 _Aver b-a-Dnily=--C_otis-amRt1an: o-f--Respondents by Consumption of Closest Relative . . . . . . . 4 . 9 . . . . a . p p . 31 15. Belief of Smoking-Cancer Relationship ...... .. . p . u . 32 vi

vi i List of Tables (Cont°d.) Page 16. Belief of Smoking®,Cancer .Relationship by Respondent and Closest Relative Compared to n n n o n e Frequencies Expected .by Chance 17. Average Daily Consumption 4 n n 18. Smoking Habi.tsof Massachusetts.Physicians in 1954 and 1959 . o o n,n . n n n oo 0 o n n o 0 0 o n o o a e - o 19, Average'.Age at Adoption9 Years Smokeds and Respondent's Age q 20. Reasons Given for, Attempting to Quit Smoking n. n o n-. .. n 21. Mention.of Specific Ailments or Doctor's Advice . n o. n.. 22. General Reasons for Giving up Cigarette Swoking < n o. n. o 23. Years S'iizce Quit or Attempted to Quit n n n n n n q:e n n q n 24. Number of Times Tried to G.ive Jp Smoking . n n. n. n n n. e . n n. n.o .. . n n... n n n .25.-Measures of Perceived Utility 26. Belief in SmokingmCancer Relationship o o. n. n e n o n.. n 27. Average Perceived Probability Differential Attached . o n., n n, n n. n n o n n n n to a Given Amount of Smoking 32 37 38 39 41 43 44 46 4-7 49 51 52 28. Aspects Liked -and Disliked About Smoking n n n n..n n n n n. 55 29. Mean Extroversion, Neuroticism, and Chance Orientation . Scores • . o b o e a o a a o 0 o n o o' o 0 0 o n o 0 4 e o 0 0 56 -30. List of,Independeat Variables LmNloyed in the Regression 9 9. 58 31. Multiple Regression on Tricho-tomous D'ascontinuation Scale ... .60 32. Correlations of Independent Variables with Three Dependent Variables 61 33. Correlations Between Four Most Important Independent Variables- , n n. o n o v n a n n n a n n a n n o on o . 63 .34. Information Heard Or Read About Smoking in Past Year .... o- 70 35.--C-orre-iat-i.-ons- of- Independent Variables -ra.i th Quadrichotornous . Scale of Smoking Behavior, Trichotomous Discontinuation Scale, and Average Daily Consumption Q n, n. n n o... n. 94

viii List of Tables (Cont°d.). ; Table Page 36, Outcome of Telephone Screeni,ng . . . . . . . . . . . 4 • • • • 110 37. Outcome of Personal Interview . . . . . . . . . . . . . . . . 112 38. Outcome of Snowball Interview . . . ~ . p . , . . . . . . . q 114

. INTRODUCTION AND SPECIFIC AIMS The Development of the Smoking-Health Controversy Current methods og constimi ng tobacco -- smoking, chewing, and snuff were being used long before the Western world came in contact with this pro- duct'.l Shortly after the voyage of Columbus, tobacco was introduced into Europe. Pipe smoking became popular in England by the end of the 16th century.2 In America, chewing tobacco was enjoyed until shortly after the Civil War. So widespread was this habit that Englishman Charles McKay suggested substituting the spittoon.for the eagle as the American national emblem.3 The cigarette did not really take a-firm hold until shortly before the first World.War.4 At the expense of other tobacco products, cigarette smoking in the United States has increased eightyfold within the last fifty years.5 ConGurrent with the.rise of tobacco consumption has been opposition to indulgence 3.n tobacco. The 17th century Puritans, who looked on the act as characteristiq of the drunken cavalier,..may have been the first group publicly I 1C. Van Proosdy, Smoking (New Yorkt,Elsevier Publishing Company, 1960), p. 172: ZLlavid M. Kissen, "Psycho-Social Factors in Cigarette Smoking Motivm ation,r1 The Med~ic_ai .Officer, CIV (December 16, 1960), p. 365. 3Proosdy, 2p.. c'it., p.- 190. 4 ~I bid., p. 176. SIbid., p. 178.

2 1 to-oppose smoking. The first recorded medical debate on the subject was held in 1605 by the Royal College of Physicians at Oxford in response to a tract written by"James I of England, who concluded that smoking is "a custome loth= same to the Eye, "hateful to the Nose, harmful to the Braine, dangerous to the Lungs,."and, in.the black stinking Fume thereof, nearest resembling the horrible Stygian Smoker of.the "Pit that is bottomless,re2 Especially militant opposition was prevalent in America in the early 20th century.wi.th the formation of the Anti-Cigaretite League. The influence of this group was so strong that by 1915 nine states passed laws banning the sale -of tobacco, to adults. The only rem.nants- of these early laws are restrictions limiting the sale.of cigarettes to adults on1y~3 Early pamphleteers attributed to smoking everything from baldness to the decline of the British Empire ("impairs the vigour and energy of the English people.,: .'R).4 Although.recent opposition to cigarettes is grounded on a firmer scientific base, the essential themes have not changed very much since : the wri tings of 'James I. -The first publication linking cigarette smoking to lung cancer appeared in the thirties. This led to a series of statistical investigations which were finally made public in December, 1953, in a statement made before the Greater New York Dental Associationo5 Four years later, the American Cancer Society 1Kissen, Loco cit. ZProosdy, 0p-. ci t<., p.. 201. • 3lbid., p. 205. 4lbido, p.' 207. 5Cited by Charles W. Day, "FeargReduction and Cigarette Marketing," Studies in Public Commuiii,cation, Committee -on Communication, The University of Chicago (Summer, 1950, pp4 48m53.