Abstract
Printing of pictorial health warnings (PHWs) on cigarette packages became obligatory by the Vietnam Law on Prevention and Control of Tobacco Harm in May 2013. Literature from high-income countries suggests that PHWs motivate smokers to quit smoking although their long-term effects have been questioned due to reduction of impact over time. This study aimed to assess the salience of PHWs and smokers' reactions towards PHWs over time. In May 2014 and May 2015, a cross-sectional questionnaire-based household survey was administered to respectively 1,462 and 1,509 Vietnamese male smokers aged 18 to 35. The result showed that salience of the PHWs 2 years after the implementation was higher than at the point of 1 year after the implementation. The proportion of respondents who tried to avoid noting the PHWs was reduced from 35% in wave 1 to 23% in wave 2. However, "Tried to avoid looking/thinking about the PHWs" increased 1.5 times the odds of presenting quit intention compared to those respondents who did not try to avoid looking/thinking about the PHWs (OR=1.5; 95%CI: 1.2-2.0). In conclusion, avoidance regarding PHWs may not work as a barrier when aiming at a higher level of quit intention. Salience of the PHWs may increase in the period shortly after their introduction onto packs but can be expected to decrease with time. In other words, it might be advisable to change or renew PHWs after a period of implementation to maintain their beneficial effects.
Highlights
Tobacco is the only legal consumer product that can kill people when it is used in accordance to manufacturer’s instruction (World Health Organization, 2008)
Printing of pictorial health warnings (PHWs) on cigarette packages became obligatory by the Vietnam Law on Prevention and Control of Tobacco Harm in May 2013
Demographic and smoking characteristic reported by this study was similar with the results of Vietnam Global Adult Tobacco Survey (GATS) 2010 with national representative sample (Vietnam Ministry of Health et al, 2010)
Summary
Tobacco is the only legal consumer product that can kill people when it is used in accordance to manufacturer’s instruction (World Health Organization, 2008). To take away the advantages of attractive cigarette packet, health warning on cigarette packet is a prominent direct mean of communicating (Hammond, 2007; Hammond, 2009; Prakit Vathesatogkit, 2010; Hammond, 2011). This type of intervention is considered as one of the most cost-effective health communication channels available in the field of tobacco control (Hammond, 2007; Hammond, 2009; International Tobacco Control Policy Evaluation Project, 2009; Prakit Vathesatogkit, 2010; Hammond, 2011). Article 11 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) requires all Member Parties to implement the health warnings on cigarette pack (World Health Organization, 2005)
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