Risk perceptions are on a pathway to behaviour or behaviour change in many models of health behaviours, including the Extended Parallel Process Model (EPPM ( Witte, 1992)), Protection Motivation Theory (PMT) ( Rogers & Protection, 1975) and the Capability, Motivation and Opportunity-Behaviour Model (COM-B Model ( Michie et al., 2011)). Understanding the beliefs that adults hold regarding risk factors for severe Covid-19 symptoms and their correlates can contribute to the design or implementation of relevant behaviour change campaigns and interventions during the current and future pandemics or other health crises.

At the same time, inaccurate beliefs or cognitive biases can lead to missed opportunities or misguided behaviours that could pose further risk and contribute to health inequalities ( Branstrom et al., 2006 Brewer et al., 2007 Ferrer & Klein, 2015 Michie et al., 2011 Shahab et al., 2018). Notwithstanding the importance of context, resources and social opportunities ( Michie et al., 2011), risk perceptions can be important influences on health behaviours and behaviour change. For example, in the UK a new campaign Better Health was launched in the summer of 2021 to align with the increased understanding of the role of obesity in Covid-19 severe outcomes ( Public Health England, 2021). Furthermore, the Covid-19 pandemic could be a teachable moment and a catalyst for a number of positive lifestyle changes with long-term health benefits ( Brust et al., 2021). Research on risk and protective factors for severe Covid-19 outcomes continues to develop, which could help to lower hospitalisations and mortality. These risk perceptions may form barriers to changing people's own unhealthy behaviours, make them less responsive to interventions that refer to the risk of Covid-19 as a motivating factor, and exacerbate inequalities in health behaviours and outcomes.ДЄs of November 2021, the Covid-19 pandemic has resulted in over 5 million deaths worldwide and over 250 million confirmed infections caused by the SARS-CoV-2 virus ( WHO, 2020). Risk perceptions for severe Covid-19 among UK adults were lower for their own health behaviours, evidencing optimism bias. Similarly, eating more fruit and vegetables was associated with classifying unhealthy diet as вЂincreasing riskвЂ™ (aORвЂЇ=вЂЇ1.37, 1.12вЂ“1.69), and exercising more with classifying regular physical activity as вЂdecreasing riskвЂ™ (aORвЂЇ=вЂЇ2.42, 1.75вЂ“3.34). Relative to those who did not, those who engaged in the following behaviours had higher odds of classifying these behaviours as (i) decreasing the risk: smoking cigarettes (adjusted odds ratios, aORs, 95% CIвЂЇ=вЂЇ2.26, 1.39вЂ“3.37), and using e-cigarettes (aORsвЂЇ=вЂЇ5.80, 3.25вЂ“10.34) (ii) having no impact: smoking cigarettes (1.98 1.42вЂ“2.76), using e-cigarettes (aORsвЂЇ=вЂЇ2.63, 1.96вЂ“3.50), drinking alcohol (aORsвЂЇ=вЂЇ1.75, 1.31вЂ“2.33) and lower odds of classifying these as increasing the risk: smoking cigarettes (aORs: 0.43, 0.32вЂ“0.56), using e-cigarettes (aORsвЂЇ=вЂЇ0.25, 0.18вЂ“0.35). People were less sure about alcohol drinking, vaping, and nicotine replacement therapy use (17.4вЂ“29.5% responding вЂdon't knowвЂ™).

The great majority (89вЂ“99%) classified age 70+, having comorbidities, being a key worker, overweight, and from an ethnic minority as increasing the risk. We used descriptive statistics and multivariable logistic regression models to assess cross-sectionally risk perceptions for severe Covid-19 symptoms and their health behaviour correlates among 2206 UK adults from the HEBECO study. Risk perceptions are important influences on health behaviours.

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