Abstract
BackgroundSeveral Asian countries have implemented pictorial health warnings on cigarette packs as suggested by the World Health Organization with various policies based on countries’ systems. The study is aimed to analyse multiple research studies on the perceived effectiveness of Pictorial Health Warnings as a deterrent to smoking intention and as a stimulant of smoking behaviour in smokers and non-smokers in Asian countries.MethodPeer-reviewed articles were identified through multiple science databases indexed by Scopus, MEDLINE or PubMed. The review was limited to articles that reported original research findings, were conducted in Asian countries and were available for review by January 2010. A PRISMA Flow diagram was used to identify the articles through the process of data screening and extractions.ResultA total of 14 original articles which met the criteria were included in the review, consisting of 12 quantitative studies and 2 studies with both quantitative and qualitative methods from 17 jurisdictions. The reviewed studies found that pictorial health warnings were associated with a greater perception of salience (reading and noticing the warning), emotional effects, and cognitive increase. Additionally, in the reviewed studies, pictorial health warnings were perceived as more effective in deterring smoking initiation and encouraging smoking cessation than text-only warnings. Several studies also evaluated the effectiveness of a new pictorial warning compared with the old one. However, the relevance of refreshing the pictures of pictorial health warnings and the length of the effective period of the implementation of pictorial health warnings were less frequently studied.ConclusionPictorial health warnings perceived as more effective in deterring smoking initiation among non-smokers and as well as in stimulating smoking cessation among smokers. Future studies on pictorial health warnings should study the relevance of changing or refreshing pictorial health warning on cigarette packages in a period of time.
Highlights
Several Asian countries have implemented pictorial health warnings on cigarette packs as suggested by the World Health Organization with various policies based on countries’ systems
To address tobacco issue in Asia, the World Health Organization (WHO) has assisted the member states in this continent to implement WHO’s Framework Convention on Tobacco Control (FCTC) which came into force in 2005
A study conducted by Scollo and Winstanley [6] found that smokers who smoked 20 cigarettes per day would be exposed to the health warnings around 7000 times each year
Summary
Several Asian countries have implemented pictorial health warnings on cigarette packs as suggested by the World Health Organization with various policies based on countries’ systems. To address tobacco issue in Asia, the World Health Organization (WHO) has assisted the member states in this continent to implement WHO’s Framework Convention on Tobacco Control (FCTC) which came into force in 2005. The WHO’s FCTC is the first global tobacco-control treaty that encourages ratifying countries to develop and implement tobacco control policies in their own countries, regulating about tobacco advertising, tobacco tax and price, smoke-free area, and health warning message on tobacco packages [3]. Graphic health warnings, which make the potential of smoking to cause diseases more real to smokers, both can improve public knowledge, and work to encourage cessation through the generation of concern stimulated. A study conducted by Scollo and Winstanley [6] found that smokers who smoked 20 cigarettes per day would be exposed to the health warnings around 7000 times each year
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