Abstract

We aimed to identify the experiences of Australian community pharmacists with smokers and their associated perceptions of effective health warnings on individual cigarette sticks. A mixed-methods online survey was distributed to Australian pharmacists through pharmacy-specific social media pages, and the Pharmaceutical Society of Australia, followed by semi-structured face-to-face interviews with pharmacists in Townsville, Australia, who were purposively sampled. The interviews continued until data saturation was achieved. Participants described their experiences with smokers, perceptions and effectiveness ratings of current cigarette packaging warnings, and 12 text warnings (divided into four themes) on individual cigarette sticks, and their general opinions on effective anti-tobacco health warnings. Seventy pharmacists participated in the survey and 17 pharmacists in the interviews. Both groups of pharmacists cited smoking-related personal or close-contact illness, pressure by family members or physicians and the financial costs of smoking as being the main drivers for quit attempts. Most interviewed pharmacists interact with smokers several times per week. Cigarette stick warnings describing mortality consequences (especially the 'minutes of life lost' warning) and the financial consequences of tobacco use were rated as significantly more effective than current packaging warnings (odds ratio [OR] = 2.23; 95% confidence interval [CI]: 1.12-4.12, P = 0.02, and 1.97; 95%CI: 1.01-3.84, P = 0.04, respectively). Pharmacists have considerable experience assisting smokers with quitting and based on these experiences believe that novel and tangible health warnings on cigarette sticks may be an effective future measure to combat tobacco use. Further research on the opinions of a more diverse range of health professionals and the general community will generate more robust findings regarding this method of intervention.

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