TY - JOUR
T1 - Impact of Graphic Pack Warnings on Adult Smokers' Quitting Activities
T2 - Findings from the ITC Southeast Asia Survey (2005-2014)
AU - Li, Lin
AU - Fathelrahman, Ahmed I.
AU - Borland, Ron
AU - Omar, Maizurah
AU - Fong, Geoffrey T.
AU - Quah, Anne C.K.
AU - Sirirassamee, Buppha
AU - Yong, Hua Hie
N1 - Funding Information:
Financial Support: This work was supported by the National Cancer Institute at the National Institutes of Health of the United States (grants R01 CA100362, P50 CA111236); the Robert Wood Johnson Foundation (045734); the Canadian Institutes of Health Research (79551, and 115016); the Malaysian Ministry of Health; and the Thai Health Promotion Foundation Research.
Publisher Copyright:
Copyright © The Author(s) 2016.
PY - 2016/6
Y1 - 2016/6
N2 - Malaysia introduced graphic health warning labels (GHWLs) on all tobacco packages in 2009. We aimed to examine if implementing GHWLs led to stronger warning reactions (e.g., thinking about the health risks of smoking) and an increase in subsequent quitting activities; and to examine how reactions changed over time since the implementation of the GHWLs in Malaysia and Thailand where GHWL size increased from 50-55% in 2010. Data came from six waves (2005-2014) of the International Tobacco Control Southeast Asia Survey. Between 3,706 and 4,422 smokers were interviewed across these two countries at each survey wave. Measures included salience of warnings, cognitive responses (i.e., thinking about the health risks and being more likely to quit smoking), forgoing cigarettes, and avoiding warnings. The main outcome was subsequent quit attempts. Following the implementation of GHWLs in Malaysia, reactions increased, in some cases to levels similar to the larger Thai warnings, but declined over time. In Thailand, reactions increased following implementation, with no decline for several years, and no clear effect of the small increase in warning size. Reactions, mainly cognitive responses, were consistently predictive of quit attempts in Thailand, but this was only consistently so in Malaysia after the change to GHWLs. In conclusion, GHWLs are responded to more frequently, and generate more quit attempts, but warning wear-out is not consistent in these two countries, perhaps due to differences in other tobacco control efforts.
AB - Malaysia introduced graphic health warning labels (GHWLs) on all tobacco packages in 2009. We aimed to examine if implementing GHWLs led to stronger warning reactions (e.g., thinking about the health risks of smoking) and an increase in subsequent quitting activities; and to examine how reactions changed over time since the implementation of the GHWLs in Malaysia and Thailand where GHWL size increased from 50-55% in 2010. Data came from six waves (2005-2014) of the International Tobacco Control Southeast Asia Survey. Between 3,706 and 4,422 smokers were interviewed across these two countries at each survey wave. Measures included salience of warnings, cognitive responses (i.e., thinking about the health risks and being more likely to quit smoking), forgoing cigarettes, and avoiding warnings. The main outcome was subsequent quit attempts. Following the implementation of GHWLs in Malaysia, reactions increased, in some cases to levels similar to the larger Thai warnings, but declined over time. In Thailand, reactions increased following implementation, with no decline for several years, and no clear effect of the small increase in warning size. Reactions, mainly cognitive responses, were consistently predictive of quit attempts in Thailand, but this was only consistently so in Malaysia after the change to GHWLs. In conclusion, GHWLs are responded to more frequently, and generate more quit attempts, but warning wear-out is not consistent in these two countries, perhaps due to differences in other tobacco control efforts.
UR - http://www.scopus.com/inward/record.url?scp=84971426932&partnerID=8YFLogxK
U2 - 10.1017/jsc.2015.21
DO - 10.1017/jsc.2015.21
M3 - Article
C2 - 27525045
AN - SCOPUS:84971426932
SN - 1834-2612
VL - 11
SP - 124
EP - 134
JO - Journal of Smoking Cessation
JF - Journal of Smoking Cessation
IS - 2
ER -