Moving from awareness to behavior remains a challenge

More than 64% of Americans believe that lifestyle and behavior influence

cancer risk.They’re right! It is estimated that 50% to 75% of cancer deaths

each year are caused by behaviors such as smoking, physical inactivity, and

poor dietary choices.

When asked what people can do to lower their chances of getting cancer,

40.8% of respondents to the Health Information National Trends Survey

(HINTS 2003) reported that never smoking or quitting smoking reduced

cancer risk. Indeed, lung cancer is the leading cause of cancer death among

men and women, and tobacco use is the single most preventable cause of

cancer death in the United States.

Many Americans recognize that eating well can reduce their risk for

cancer: 25% of Americans report that eating a better diet can reduce a

person’s risk of getting cancer. In fact, diets high in fat and low in fruits and

vegetables are linked with several types of cancer.

The charts on this page summarize population estimates of people’s

perceptions of the role of lifestyle in cancer, and behaviors they believe

can reduce cancer risk. Interestingly, while most Americans know the

dangers of smoking and its link to lung cancer, 48% inaccurately believe

that breast and prostate cancers exact a greater annual death toll than

lung cancer. Furthermore, 54% of Americans report that there is nothing

they would like to change to reduce their own risk.

Although the American public demonstrates awareness of key cancer

prevention activities, 15% of Americans, more than 32 million, believe that

nothing can reduce a person’s cancer risk. Furthermore, 1% of Americans,

over 3 million, are not able to pinpoint a specific action that they could

take to reduce their own risk of getting cancer.

Do you agree or disagree that there’s not much people

can do to lower their chances of getting cancer?

Estimated U.S. Population Percentage

Health Information National Trends Survey (HINTS) (hints.cancer.gov) HINTS 2003 Database,

National Cancer Institute, DCCPS, Behavioral Research Program, Health Communication and

Informatics Research Branch. Released June 2004, based on the April 2003 data collection.

Strongly agree 5.97%

Somewhat agree 20.99%

No opinion 8.06%

Somewhat disagree 32.14%

Strongly disagree 32.83%

40.8% Don't smo

25.3% Eat better/

15.5% No/nothin

6.3% Other

4.5% Get a check

3.5% Exercise/exe

2% Stay out of the 

What Do Smokers Believe 

Their Risk for Lung Cance

In a study using HINTS 2003 data, investigators 

current smokers significantly underestimate the

developing lung cancer and other tobacco-relat

Smokers think that their own risk for lung canc

than the risk of the average smoker. In addition

showed that smokers underestimate the exten

smoking elevates their lung cancer risk above t

smokers: more than half of current smokers re

lung cancer risk as no more than twice that of 

in fact, even for light smokers in the sample, the

be about nine times the non-smoker’s risk.

Although 13% of the respondents to HINTS 20

quitting smoking was a behavior they’d like to c

reduce their cancer risk, many smokers and for

endorse several myths about cancer risk reduc

than half mistakenly think that exercise can “un

the negative health consequences of smoking, a

one third believe that vitamins are beneficial in 

the effects of tobacco use.

Quick Facts:

• 64% of Americans believe that cancer risk

can be reduced.

• 54% of Americans say that there is nothin

their lifestyle they would change to reduc

their risk for cancer.

• 10 years after quitting smoking, a person's 

getting lung cancer is about one third to o

that of people who continue to smoke.

• NCI recommends eating 5 to 9 servings o

vegetables per day to protect against can

colon, mouth, pharynx, esophagus, stomac
Age

• Of those respondents who said that they’d like to change

their diets to reduce their own risk for cancer, nutrition was

mentioned more frequently by those aged 35-64 (34.1%)

compared with those 18-34 (26.2%) and those 65 and older

(29.5%).

• A higher percentage of respondents aged 18-34 (43.5%) said

they’d like to quit or avoid smoking to reduce their cancer

risk compared with respondents aged 35-64 (30.3%) and

those 65 and older (20.6%).

• A higher percentage of females (33.1%) than mal

said they’d like to eat a better diet to help preve

• A higher percentage of males (40.3%) than femal

identified smoking cessation or avoidance as a ne

change to reduce their cancer risk.

• A healthy lifestyle including exercise and weight 

identified as a desired change by a higher percen

females (30.3%) compared with males (19.3%).

How Can HINTS Inform Your Work?

Americans are getting the message that some cancers are preventable, but public health and communication professiona

challenged to motivate behavior change in the areas of smoking cessation, physical activity, diet, sun safety, and cancer sc

Key implications from HINTS (2003) suggest that

• Smokers underestimate their risk for lung cancer and other tobacco-related illnesses; efforts to emphasize individual 

and the benefits of quitting are needed.

• Most people are aware of the health-promoting behaviors that can reduce cancer risk. Reinforcing messages and prov

means and support for behavioral change is important.

• Many people are not ready or willing to embark on personal behavior change to reduce their cancer risk. Education, 

and support are still important intervention points.

• While people are generally aware of and often desire behavioral change for reducing cancer risk, differences in aware

behavioral strategies for reducing risk by age, race, and gender reveal population targets for intervention.

About HINTS

The National Cancer Institute (NCI) fielded the first Health Information National Trends Survey (HINTS 2003) in 2002 and 2003, su

6,369 Americans. HINTS was created to monitor changes in the rapidly evolving field of health communication.The survey data can b

understand how adults 18 years and older use different communication channels to obtain health information for themselves and the

and to create more effective health communication strategies across populations.

HINTS Briefs provide a snapshot of noteworthy, data-driven research findings.They introduce population-level estimates for specific q

the survey and summarize significant research findings that are a result of analyzing how age, race, and gender influence specific outco

For More Information on Cancer

• Call the NCI Cancer Information Service at 1-800-4-CANCER

• Visit http://cancer.gov 

• Order NCI publications at https://cissecure.nci.nih.gov/ncipubs/

References Used in This HINTS Brief

NCI’s Cancer Trends Progress Report 2005, http://progressreport.cance

Weinstein ND, Marcus SE, Moser RP. Smokers' unrealistic optimism abou

Tob Control. 2005 Feb;14(1):55-9.

March 2006