Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of an Experimental Study in Four Asian Countries.

Jessica Reid,A Hussain,Nigar Nargis,Prakash Gupta,Seema Mutti-Packer,Qiang Li,David Hammond,Jiang Yuan

doi:10.3390/ijerph14080868

Abstract

Cigarette package health warnings can be an important and low-cost means of communicating the health risks of smoking. We examined whether viewing health warnings in an experimental study influenced beliefs about the health effects of smoking, by conducting surveys with ~500 adult male smokers and ~500 male and female youth (age 16–18) in Beijing, China (n = 1070), Mumbai area, India (n = 1012), Dhaka, Bangladesh (n = 1018), and Republic of Korea (n = 1362). Each respondent was randomly assigned to view and rate pictorial health warnings for 2 of 15 different health effects, after which they reported beliefs about whether smoking caused 12 health effects. Respondents who viewed relevant health warnings (vs. other warnings) were significantly more likely to believe that smoking caused that particular health effect, for several health effects in each sample. Approximately three-quarters of respondents in China (Beijing), Bangladesh (Dhaka), and Korea (which had general, text-only warnings) thought that cigarette packages should display more health information, compared to approximately half of respondents in the Mumbai area, India (which had detailed pictorial warnings). Pictorial health warnings that convey the risk of specific health effects from smoking can increase beliefs and knowledge about the health consequences of smoking, particularly for health effects that are lesser-known.

Highlights

Worldwide, tobacco use remains the leading preventable cause of death [1]
Given the variation between countries in their current warning labels, this study examined opinions about the amount of health information provided on cigarette packages, and whether opinions varied by country, age group and smoking status
The findings indicate that within samples of adult smokers and youth from four localities in southern and eastern Asia, viewing health warnings increased beliefs that smoking caused some of the health effects depicted, in China and Korea

Summary

Introduction

Tobacco use remains the leading preventable cause of death [1]. Much of the global burden of tobacco use is borne by low- and middle-income countries, in Asia. China is the largest tobacco market in the world, with more than 300 million smokers, followed by India, with over 100 million [2]. Bangladesh has approximately 22 million smokers; nearly half (44.7%) of adult males (and 1.5% of females) smoke tobacco [2]. Res. Public Health 2017, 14, 868; doi:10.3390/ijerph14080868 www.mdpi.com/journal/ijerph

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Discussion

Conclusion