Motivation to quit smoking and acceptability of shocking warnings on cigarette packages in Lebanon

Abstract

IntroductionHealth warnings on tobacco packages have been considered an essential pillar in filling the gap of knowledge and communicating the health risks of tobacco use to consumers. Our primary objective was to report the perception of smokers on the textual health warnings already appearing on tobacco packages in Lebanon versus shocking pictures about the health-related smoking consequences and to evaluate their impact on smoking behaviors and motivation.MethodsA pilot cross-sectional study was undertaken between 2013 and 2015 in five hospitals in Lebanon. Participants answered a questionnaire inquiring about sociodemographic characteristics, chronic respiratory symptoms, smoking behavior and motivation to quit smoking. Only-text warning versus shocking pictures was shown to the smokers during the interview.ResultsExactly 66% of the participants reported that they thought shocking pictorial warnings would hypothetically be more effective tools to reduce/quit tobacco consumption compared to only textual warnings. Also, 31.9% of the smokers who were motivated to stop smoking reported that they actually had stopped smoking for at least 1 month secondary to the textual warnings effects. A higher motivation to quit cigarette smoking was seen among the following groups of smokers: males (odds ratio [OR] =1.8, P=0.02), who had stopped smoking for at least 1 month during the last year due to textual warning (OR =2.79, P<0.001), who considered it very important to report health warning on cigarette packs (OR =1.92, P=0.01), who had chronic expectoration (OR =1.81, P=0.06) and who would change their favorite cigarette pack if they found shocking images on the pack (OR =1.95, P=0.004).ConclusionLow-dependent smokers and highly motivated to quit smokers appeared to be more hypothetically susceptible to shocking pictorial warnings. Motivation to quit was associated with sensitivity to warnings, but not with the presence of all chronic respiratory symptoms.

Social Tobacco Warnings Can Influence Implicit Associations and Explicit Cognitions

“…Correlational studies demonstrated that warning labels can lower the appeal of the package, and create higher levels of negative affect such as anxiety (Kees et al, 2006; Mannocci et al, 2012; Layoun et al, 2017). Furthermore, audiences are much more likely to pay attention to messages with graphic images than those with text only (O’Hegarty et al, 2006; Layoun et al, 2017).…”

Influence of health warnings present on cigarette packets, on motivation to quit smoking, among smokers in a slum of Kolkata

“…Only 9% actually quitted smoking due health warning as compared to similar study by Layoun et al, in which textual warnings have actually triggered a smoking cessation trial for at least 1 month and a reduction in the number of cigarettes smoked a day in 21% and 19.1% of cigarette smokers respectively. 6 In a study by Bittencourt et al women with elementary education or below and those some/complete high school think about quitting smoking after seeing pictorial warning than women with higher education (OR=4.85; p=0.0028 and OR=2.91; p=0.05), respectively). 15 Similarly 74.2% smokers felt that it is necessary to keep health warning on cigarette packets compared to above study by Layoun et al 6 According to a study by Vanishree et al 22.9% of the tobacco users had positive attitude towards the pictorial warnings and in this study also 86.4% of the study subject believed in risk of the disease as shown in health warning on cigarette packets.…”

“…6 In a study by Bittencourt et al women with elementary education or below and those some/complete high school think about quitting smoking after seeing pictorial warning than women with higher education (OR=4.85; p=0.0028 and OR=2.91; p=0.05), respectively). 15 Similarly 74.2% smokers felt that it is necessary to keep health warning on cigarette packets compared to above study by Layoun et al 6 According to a study by Vanishree et al 22.9% of the tobacco users had positive attitude towards the pictorial warnings and in this study also 86.4% of the study subject believed in risk of the disease as shown in health warning on cigarette packets. 16 According to a study by Heydari et al smokers had a significantly higher knowledge about the pictorial warning labels on cigarette packs (p<0.001) and no significant difference was observed between the Iranian or foreign brands in terms of smoking rate after applying the pictorial warning labels.…”

“…Accordance to a study by Layoun et al 14.8% adult smokers have changed their smoking habit due to health warning, who were motivated to quit smoking were secondarily to health warning on cigarette packet cigarette packet made more quiet attempts. 5,6 This prevalence was taken for sample size calculation. With Z=1.96 for 95% confidence limit and 9% absolute precision the sample size was calculated to be:…”

“…9 Variables for health warning on cigarette packs contained questions on knowledge of smokers about the health warning and their response to it, motivation to quit after seeing health warning ,actual reason for quitting if required or quitted. [5][6][7][10][11][12][13]…”