Abstract
BackgroundGraphic health warning labels (GHWLs) on tobacco products are more effective than text warnings for communicating the risk of smoking. The implementation of GHWLs can prevent adolescents from initiating smoking. Therefore, this study examined the association between GHWLs newly implemented on December 23, 2016, in South Korea and attitudes toward smoking among adolescents.MethodsThis post-implementation cross-sectional analysis examined the responses of 62,276 students (31,624 boys and 30,652 girls) who participated in the 2017 Web-based Korean Youth Risk Behavior Survey, which was completed anonymously as a self-administered questionnaire by middle and high school students. Multinomial logistic regression was applied to explore the attitudes toward smoking among the youth (13–18 years old) who have been exposed to GHWLs in order to identify relationship of exposure to the GHWLs with smoking initiation and awareness of the danger of smoking.ResultsSix months after implementation, 69.4% of adolescents reported having been exposed to GHWLs in the previous 30 days. Among those exposed to GHWLs both boys and girls in grade 7 were significantly more likely than grade 12 high school students to decide not to start smoking (boys: AOR = 3.96, 95% CI 3.31–4.75, p < 0.001; girls: AOR = 2.76, 95% CI 2.32–3.30, p < 0.001) and to think that smoking was dangerous to their health (boys: AOR = 3.01, 95% CI 2.52–3.58, p < 0.001; girls: AOR = 2.42, 95% CI 2.03–3.88, p < 0.001) after seeing GHWLs. These associations were greater for adolescents who had experienced smoking-prevention education or had been exposed to anti-tobacco advertisements. However, those who smoked, used e-cigarettes, or experienced secondhand smoking were significantly less likely to decide not to smoke and to view smoking as dangerous.ConclusionsTo maintain the perception of the harm of tobacco from childhood through adolescence, the government should implement both comprehensive tobacco controls, including smoking-prevention education in schools, and measures to encourage a smoke-free environment in homes.
Highlights
Graphic health warning labels (GHWLs) on tobacco products are more effective than text warnings for communicating the risk of smoking
16.1% (18.2% of boys and 13.2% of girls) were current alcohol users. Those who were exposed to secondhand smoke, tobacco advertisements, or anti-tobacco advertisements were more likely to have been exposed to GHWLs than those who were not
In the past 12 months, 74.0% of boys and 76.5% of girls who had been educated about smoking prevention at school were exposed to GHWLs compared to only 50.6% of boys and 61.2% of girls who had not received such education
Summary
Participants Data for this study were obtained from the 2017 Korea Youth Risk Behavior Web-based Survey (KYRBWS), which is conducted jointly by the Korean Ministry of Education, the Korean Ministry of Health and Welfare, and the Korean Center for Disease Control and Prevention to monitor the health behavior of South Korean adolescents [20]. Exposure to GHWLs during the past 30 days To assess their exposure to GHWLs, participants were asked the following: “For the past 30 days, did you see a graphic health warning on tobacco products?” The responses were classified as (1) No and (2) Yes. Perceived effectiveness of GHWLs after having viewed a warning This study used two questions from the Korea Youth Risk Behavior Web-based Survey. Multinomial logistic regression was applied to explore the relationship between GHWLs and perceived effectiveness among students who had seen GHWLs on tobacco products in the past 30 days In this test, the following covariates were adjusted for region, family living structure, perceived academic record, perceived household economic status, perceived stress, experience of depression, and current alcohol use; they are presented as adjusted odds ratios (AORs) and 95% confidence intervals (CIs). The data analyses were performed using SPSS ver. 24, and pvalues < 0.05 were considered indicative of significance
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
