Gender differences in the perceived effectiveness of female-focused graphic health warnings against smoking in South Korea

Abstract

Objective: Numerous studies have examined the effectiveness of graphic health warnings on different population segments, including male and female smokers, in an effort to reduce health disparities in Europe and the USA. However, research exploring the impact of gender-specific tobacco control interventions on Asian smokers is lacking. This study aimed to assess the perceived effectiveness of graphic health warning images featuring women smokers compared to gender-neutral warnings on South Korean women and men, by smoking status. Setting: Online survey with 1,200 adults (500 women; 475 smokers) in South Korea Design: A survey with four graphic health warnings (two female-focused and two gender-neutral warnings). Method: Participants were assigned to view two female-focused warnings (depicting smoking during pregnancy and risk of premature skin aging) or two gender-neutral warnings (depicting lung cancer and oral cancer), and rated their effectiveness in terms of persuading smokers to quit smoking and non-smokers to not begin smoking. Results: A significant interaction between gender and smoking status was found with the pregnancy warning. A post hoc comparison showed a significant difference between female smokers and female non-smokers, between male smokers and male non-smokers, and between female non-smokers and male non-smokers in their perceptions of warning effectiveness. Female non-smokers showed higher perceived effectiveness than male non-smokers and female smokers. Male non-smokers rated its perceived effectiveness lower than male smokers. Regarding the gender-neutral warnings, a participant’s age affected their perceived effectiveness of the cancer warnings. Conclusion: Findings suggest that graphic health warnings of smoking during pregnancy are perceived more effective by female non-smokers than female smokers and male non-smokers. Gender-neutral warnings with cancer images are perceived differently by age group. Future studies need to examine how social and cultural factors surrounding female smokers in South Korea affect their perceptions about female-focused warnings and the effects of the warnings on their motivation to quit smoking.