Smokers' responses toward cigarette pack warning labels in predicting quit intention, stage of change, and self-efficacy

Abstract

of succeeding. Malaysian smokers appear to respond to warnings in ways comparable with those from developed countries. IntroductionTobacco use is a global problem, resulting in a wide range of diseases and death and with great economic costs. By the year 2020, worldwide tobacco-related deaths are estimated to reach 10 million every year, two thirds of which will be in developing countries ( Mackay, Eriksen, & Shafey, 2006 Smokers' interest in quitting and their self-effi cacy for doing so mediate and predict behavior change and the maintenance of change ( Cote, Godin, & Gagne, 2004 ;DiClemente, 1981 ;DiClemente, Prochaska, & Gibertini, 1985 ;Dijkstra, Roijackers, & De Vries, 1998 ;Dino, Kamal, Horn, Kalsekar, & Fernandes, 2004 ;Fong et al., 2006 ;Haddad & Petro-Nustas, 2006 ;MacKenzie, Pereira, & Mehler, 2004 ). Figure 1A portrays the relationship between those mediators and behavior change.Interest in quitting (or intention to quit) has been conceptualized both as a continuous variable and as a series of stages. The latter has been popularized by the transtheoretical model of Prochaska and DiClemente ( Maibach & Cotton, AbstractIntroduction: This paper is concerned with the effects of cigarette pack warning labels on quitting intentions. We examined whether different responses among smokers toward cigarette pack warning labels could predict quit intentions and self-efficacy in quitting. Variables studied were " noticing warning labels during last month, " " reading or looking closely at warning labels, " " avoiding looking at labels during last month, " " thinking about health risks of smoking because of the warning labels, " more likely to quit because of the warning labels, " and " stopping from having a cigarette when about to smoke one because of the labels. "Methods: A total of 2,006 adult smokers in Malaysia were surveyed in face-to-face interviews using a standardized questionnaire. Of those, 1,919 male smokers were included in the analyses. Results:The responses " more likely to quit because of the warning labels " and " stopped from having a cigarette when about to smoke one " signifi cantly predicted all stages of change and self-effi cacy, independent of the other measures. In addition, thinking about the health risks and reading the warnings more often added extra predictive capacity but only in the early stages of contemplating change.Discussion: Less intense processing of the information may be important in initiating thoughts, but cognitions about quitting and foregoing cigarettes are the key mechanisms by which warnings stimulate quitting intentions and help smokers feel capable

The lower effectiveness of text-only health warnings in China compared to pictorial warnings in Malaysia: findings from the ITC project

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The biomedicalisation of smoking cessation: a mixed methods study of lay perspectives on nicotine addiction

“…The self-efficacy item was measured on a five point scale, but for the purposes of this analysis it was dichotomised so that those with low self-efficacy (those who had responded that they were not at all or slightly sure they could quit within the next six months) were compared to those who had selected one of the remaining responses (moderately sure, very sure, extremely sure). This dichotomisation is consistent with a previous study (Fathelrahman et al, 2009), and its suitability was assessed by cross-tabulations of self-efficacy responses with other important variables. These showed that those who reported being not at all sure or a little sure that they could quit had similar responses on other questions.…”

Conceptual challenges in the translation of research into practice: it’s not just a matter of “communication”

“…It was then expanded to several culturally distinct (e. g., France, Germany, The Netherlands) countries and countries that are both culturally distinct and developing (e.g., China, Thailand, Malaysia). This work is showing that while some policies appear to have essentially the same effects regardless of country (e.g., the impact of strong health warnings on packs [40,41]), some policies appear to have quite different impacts across countries. For example, there is high value placed on, and high compliance with laws mandating smoke-free public places in many jurisdictions, but they have been problematic in others, for example, Germany.…”