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Given the public health burden of smoking and the knowledge that many smokers begin during adolescence and young adulthood, understanding how decisions about smoking behaviors are made is of considerable importance. Most health decision-making models relevant to understandingbenefits smoking behavior posit that beliefs about the costs and of smoking are an important influence on decision making. However, these models differ in how other factors (e.g., outcome importance, perceived positivity or negativity of outcome) are weighted in cost-benefit analyses. We examined the relative efficacy of different weightings in cost/benefit formulations to predict young adults' current smoking behavior and intentions to smoke in the future. Smoking and non-smoking participants listed advantages and disadvantages of smoking and then rated the importance and positivity/negativity of each outcome. Number of consequences listed, consequences weighted by importance, by positivity/negativity, and by an importance, x positivity/negativity interaction were examined as predictors of both current smoking status and reported intentions to smoke in 5 years. Both importance and positivity/negativity (but not their interaction) predicted current smoking status, whereas importance alone was the strongest predictor of future smoking intentions. This suggests the possibility that different decision-making processes might underlie future behavioral intentions relative to those that guide current behavior.

Young adults' judgments of the costs and benefits of smoking: The predictive efficacy of different outcome weightings in behavioral decision making