Smoking, education and the ability to predict own survival probabilities

Subjective survival probabilities (SSPs) are a good predictor of mortality, go beyond the aggregate description of survival defined by life tables, and are important for individuals' decision-making in later life. However, despite the well-known mortality differentials by education as well as by characteristics such as smoking, little investigation has focused on SSPs by population sub-groups defined as a combination of these two characteristics.

We use data on individuals aged 50-89 from the Health and Retirement Study (HRS) carried out in the USA between 2000 and 2012 (N = 23,895). Respondents were asked to assess the probability to survive to a given target age according to their age at the time of the survey. We assess how individuals' SSPs and estimated objective survival probabilities (OSPs) vary by education and smoking and calculate, for each respondent, the gap between them.

Consistently with real mortality patterns, smokers report the lowest SSPs in each of the three considered education groups. When comparing SSPs and OSPs we find that all groups tend to underestimate survival. Within each education group, past smokers better predict their survival probability. Current smokers with low education show the highest probability to overestimate their survival.

Smokers are aware of their lower life expectancy. Still, a considerable proportion of them overestimate their survival probabilities, independently of their level of education.