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Stronger pack warnings predict quitting more than weaker ones: Finding from the ITC Malaysia and Thailand surveys

Fathelrahman, Ahmed I, Li, Lin, Borland, Ron, Yong, Hua-Hie, Omar, Maizurah, Awang, Rahmat, Sirirassamee, Buppha, Fong, Geoffrey T and Hammond, David 2013, Stronger pack warnings predict quitting more than weaker ones: Finding from the ITC Malaysia and Thailand surveys, Tobacco induced diseases, vol. 11, pp. 1-8, doi: 10.1186/1617-9625-11-20.

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Title Stronger pack warnings predict quitting more than weaker ones: Finding from the ITC Malaysia and Thailand surveys
Author(s) Fathelrahman, Ahmed I
Li, Lin
Borland, Ron
Yong, Hua-HieORCID iD for Yong, Hua-Hie orcid.org/0000-0001-8167-6173
Omar, Maizurah
Awang, Rahmat
Sirirassamee, Buppha
Fong, Geoffrey T
Hammond, David
Journal name Tobacco induced diseases
Volume number 11
Article ID 20
Start page 1
End page 8
Total pages 8
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2013-09-20
ISSN 1617-9625
Keyword(s) cigarette package warning labels
health knowledge
quitting behavior
Malaysia, Thailand
Summary Background: We examined the impact of cigarette pack warning labels on interest in quitting and subsequent quit attempts among adult smokers in Malaysia and Thailand.

Methods. Two overlapping cohorts of adults who reported smoking factory- made cigarettes from Malaysia and Thailand were interviewed face-to-face (3189 were surveyed at baseline and 1781 re-contacted at Wave 2; 2361 current smokers were surveyed at Wave 2 and 1586 re-contacted at Wave 3). In Thailand at baseline, large text only warnings were assessed, while at Wave 2 new large graphic warnings were assessed. In Malaysia, during both waves small text only warnings were in effect. Reactions were used to predict interest in quitting, and to predict making quit attempts over the following inter-wave interval.

Results: Multivariate predictors of "interest in quitting" were comparable across countries, but predictors of quit attempts varied. In both countries, cognitive reactions to warnings (adjusted ORs; 1.57 & 1.69 for Malaysia at wave 1 and wave 2 respectively and 1.29 & 1.19 for Thailand at wave 1 and wave 2 respectively), forgoing a cigarette (except Wave 2 in Malaysia) (adjusted ORs; 1.77 for Malaysia at wave 1 and 1.54 & 2.32 for Thailand at wave 1 and wave 2 respectively), and baseline knowledge (except wave 2 in both countries) (adjusted ORs; 1.71 & 1.51 for Malaysia and Thailand respectively) were positively associated with interest in quitting at that wave. In Thailand only, "cognitive reactions to warnings" (adjusted ORs; 1.12 & 1.23 at wave 1 and wave 2 respectively), "forgoing a cigarette" (adjusted OR = 1.55 at wave 2 only) and "an interest in quitting" (adjusted ORs; 1.61 & 2.85 at wave 1 and wave 2 respectively) were positively associated with quit attempts over the following inter-wave interval. Salience was negatively associated with subsequent quit attempts in both Malaysia and Thailand, but at Wave 2 only (adjusted ORs; 0.89 & 0.88 for Malaysia and Thailand respectively).

Conclusion: Warnings appear to have common mechanisms for influencing quitting regardless of warning strength. The larger and more informative Thai warnings were associated with higher levels of reactions predictive of quitting and stronger associations with subsequent quitting, demonstrating their greater potency.
Language eng
DOI 10.1186/1617-9625-11-20
Field of Research 1103 Clinical Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30108372

Document type: Journal Article
Collections: School of Psychology
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