Role of Pictorial Warning on Cigarette Packets in Tobacco Cessation: A Questionnaire Survey Among Cigarette Smokers in Chennai, India

Abstract

Background: Tobacco is used in various forms (smoking/smokeless forms) all over the world today. The World Health Organization reports it to be the leading preventable cause of death worldwide, and estimates that it currently causes 5.4 million deaths per year. Rates of smoking have leveled off or declined in developed countries. However, they continue to rise in the developing countries. As in other developing countries, India too suffers a stage of the tobacco epidemic, hosting nearly 17% of the world´s smokers, with the number constantly on the rise. According to the report of the Tobacco Control in India, 800,000-900,000 Indians die annually due to diseases attributable to tobacco. Among these deaths, 50% are due to cancer and 40% are other reported health-related problems such as cardiovascular and lung disorders. Tobacco is used by various groups of people irrespective of their social, economic or educational background, and majority of them use it despite knowing the hazards to their health. Warning labels on cigarette packages are meant to communicate such smoking-associated risks. The study is designed to find out the effectiveness of pictorial warnings present on cigarette packets in India for tobacco cessation among cigarette smokers. Methodology: A questionnaire was distributed to 800 current smokers attending an outpatient department of a college. Statistical analysis was done to find association between socioeconomic status and effectiveness of pictures to quit cigarette smoking. Results: 48% smokers perceive text warning is an efficient method to create awareness. 56% emphasized the importance of pictorial warning and greater area to be covered. 43% felt that warning on cigarette packets helped them to quit smoking. Conclusions: Though pictorial warning is an effective method to improve the awareness among smokers on the ill effects of smoking, the size, area covered and the position of the picture on cigarette packets needs to be reviewed to improve the quit rate.