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Impact of graphic pack warnings on adult smokers' quitting activities: findings from the ITC Southeast Asia Survey (2005-2014)

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posted on 01.06.2016, 00:00 authored by L Li, A I Fathelrahman, R Borland, M Omar, G T Fong, A C K Quah, B Sirirassamee, Hua YongHua Yong
Copyright © The Author(s) 2016. Malaysia introduced graphic health warning labels (GHWLs) on all tobacco packages in 2009. We aimed to examine if implementing GHWLs led to stronger warning reactions (e.g., thinking about the health risks of smoking) and an increase in subsequent quitting activities; and to examine how reactions changed over time since the implementation of the GHWLs in Malaysia and Thailand where GHWL size increased from 50-55% in 2010. Data came from six waves (2005-2014) of the International Tobacco Control Southeast Asia Survey. Between 3,706 and 4,422 smokers were interviewed across these two countries at each survey wave. Measures included salience of warnings, cognitive responses (i.e., thinking about the health risks and being more likely to quit smoking), forgoing cigarettes, and avoiding warnings. The main outcome was subsequent quit attempts. Following the implementation of GHWLs in Malaysia, reactions increased, in some cases to levels similar to the larger Thai warnings, but declined over time. In Thailand, reactions increased following implementation, with no decline for several years, and no clear effect of the small increase in warning size. Reactions, mainly cognitive responses, were consistently predictive of quit attempts in Thailand, but this was only consistently so in Malaysia after the change to GHWLs. In conclusion, GHWLs are responded to more frequently, and generate more quit attempts, but warning wear-out is not consistent in these two countries, perhaps due to differences in other tobacco control efforts.

History

Journal

Journal of smoking cessation

Volume

11

Issue

2

Pagination

124 - 134

Publisher

Cambridge University Press

Location

Cambridge, Eng.

eISSN

1834-2612

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2016, The Authors