Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Perceived effectiveness of pictorial health warnings on changes in smoking behaviour in Asia: a literature review

Authors: Suci Puspita Ratih, Dewi Susanna

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

Several Asian countries have implemented pictorial health warnings on cigarette packs as suggested by the World Health Organization with various policies based on countries’ systems. The study is aimed to analyse multiple research studies on the perceived effectiveness of Pictorial Health Warnings as a deterrent to smoking intention and as a stimulant of smoking behaviour in smokers and non-smokers in Asian countries.

Method

Peer-reviewed articles were identified through multiple science databases indexed by Scopus, MEDLINE or PubMed. The review was limited to articles that reported original research findings, were conducted in Asian countries and were available for review by January 2010. A PRISMA Flow diagram was used to identify the articles through the process of data screening and extractions.

Result

A total of 14 original articles which met the criteria were included in the review, consisting of 12 quantitative studies and 2 studies with both quantitative and qualitative methods from 17 jurisdictions. The reviewed studies found that pictorial health warnings were associated with a greater perception of salience (reading and noticing the warning), emotional effects, and cognitive increase. Additionally, in the reviewed studies, pictorial health warnings were perceived as more effective in deterring smoking initiation and encouraging smoking cessation than text-only warnings. Several studies also evaluated the effectiveness of a new pictorial warning compared with the old one. However, the relevance of refreshing the pictures of pictorial health warnings and the length of the effective period of the implementation of pictorial health warnings were less frequently studied.

Conclusion

Pictorial health warnings perceived as more effective in deterring smoking initiation among non-smokers and as well as in stimulating smoking cessation among smokers. Future studies on pictorial health warnings should study the relevance of changing or refreshing pictorial health warning on cigarette packages in a period of time.
Literature
1.
Mackay J, Ritthiphakdee B, Reddy KS. Tobacco control in Asia. Lancet. 2013;381(9877):1581.CrossRef
2.
World Health Organization. Conference of the parties to the WHO framework convention on tobacco control: decisions. Geneva: WHO; 2011.
3.
Aditama TY, Pradono J, Rahman K, Warren CW, Jones NR, Asma S, et al. linking global youth tobacco survey (GYTS) data to the WHO framework convention on tobacco control: the case for Indonesia. Prev Med. 2008;47(Supplement 1):S11–S4.CrossRef
4.
Fathelrahman AI, Omar M, Awang R, Cummings KM, Borland R, Bin Mohd Samin AS. Impact of the new Malaysian cigarette pack warnings on smokers’ awareness of health risks and interest in quitting smoking. Int J Environ Res Public Health. 2010;7(11):4089–99.CrossRef
5.
Balhara YP, Gupta R. Revised size of pictorial warning on cigarette packages-a step in right direction. Nicotine Tob Res. 2015;17(11):1401–2.CrossRef
6.
Scollo MM, Winstanley MH. Tobacco in Australia: facts and issues. Melbourne: Cancer Council Victoria; 2008.
7.
Peebles K, Hall MG, Pepper JK, Byron MJ, Noar SM, Brewer NT. Adolescents’ responses to pictorial warnings on their Parents’ cigarette packs. J Adolesc Health. 2016;59(6):635–41.CrossRef
8.
Pepper JK, Cameron LD, Reiter PL, McRee A-L, Brewer NT. Non-smoking male Adolescents’ reactions to cigarette warnings. PLoS One. 2013;8(8):e65533.CrossRef
9.
Cameron LD, Williams B. Which images and features in graphic cigarette warnings predict their perceived effectiveness? Findings from an online survey of residents in the UK. Ann Behav Med. 2015;49(5):639–49.CrossRef
10.
Li HCW, Chan SS, Lam TH. Smoking among Hong Kong Chinese women: behavior, attitudes and experience. BMC Public Health. 2015;15(1):183.CrossRef
11.
Hammond D. Health warning messages on tobacco products: a review. Tob Control. 2011;20(5):327.CrossRef
12.
13.
Yong H-H, Fong GT, Driezen P, Borland R, Quah ACK, Sirirassamee B, et al. Adult smokers’ reactions to pictorial health warning labels on cigarette packs in Thailand and moderating effects of type of cigarette smoked: findings from the international tobacco control Southeast Asia survey. Nicotine Tob Res. 2013;15(8):1339–47.CrossRef
14.
Swartz MK. The PRISMA statement: a guideline for systematic reviews and meta-analyses. J Pediatr Health Care. 2011;25(1):1–2.CrossRef
15.
Wu D, Yang T, Cottrell RR, Zhou H, Yang XY, Zhang Y. The effects of tobacco-related health-warning images on intention to quit smoking among urban Chinese smokers. Health Educ J. 2014;74(3):287–98.CrossRef
16.
Zaidi SM, Bikak AL, Shaheryar A, Imam SH, Khan JA. Perceptions of anti-smoking messages amongst high school students in Pakistan. BMC Public Health. 2011;11:117.CrossRef
17.
Sychareun V, Hansana V, Phengsavanh A, Chaleunvong K, Tomson T. Perceptions and acceptability of pictorial health warning labels vs text only--a cross-sectional study in Lao PDR. BMC Public Health. 2015;15:1094.CrossRef
18.
Elton-Marshall T, Xu SS, Meng G, Quah AC, Sansone GC, Feng G, et al. The lower effectiveness of text-only health warnings in China compared to pictorial health warnings in Malaysia. Tob Control. 2015;24(Suppl 4):iv6–13.PubMed
19.
Mutti S, Reid JL, Gupta PC, Pednekar MS, Dhumal G, Nargis N, et al. Perceived effectiveness of text and pictorial health warnings for smokeless tobacco packages in Navi Mumbai, India, and Dhaka, Bangladesh: findings from an experimental study. Tob Control. 2016;25(4):437.CrossRef
20.
Awaisu A, Hagi A, Ashour MA, Kheir N. Pictorial health warnings on cigarette packages in Qatar: preimplementation awareness and perceptions of ever-smokers versus never-smokers. Nicotine Tob Res. 2013;15(10):1765–72.CrossRef
21.
Dien A, Rita D, Amry I, Ferdinand S, James FT, David H, et al. Effectiveness of pictorial health warning labels for Indonesia’s cigarette packages. Depok: Center for Health Research Universitas Indonesia; 2015.
22.
Fong GT, Hammond D, Jiang Y, Li Q, Quah AC, Driezen P, et al. Perceptions of tobacco health warnings in China compared with picture and text-only health warnings from other countries: an experimental study. Tob Control. 2010;19(Suppl 2):i69–77.CrossRef
23.
Hawari FI, Bader RK, Beano HM, Obeidat NA, Ayub HS, Habashneh MA, et al. Perceptions of young Jordanian adults to proposed anti-tobacco pictorial warning labels. BMC Public Health. 2011;11:414.CrossRef
24.
Behera BK, Tyagi A, Rani B, Chawla S, Kumar BJ, Sahoo MC. How effective pictorial warnings on tobacco product are? A cross sectional study from North India. Indian J Health Wellbeing. 2013;4(5):1108–11.
25.
Tugrul TO. The impacts of fear and disgust on the perceived effectiveness of smoking warning labels. Asia Pac J Public Health. 2013;27(2):NP506–NP12.CrossRef
26.
Auemaneekul N, Silpasuwan P, Sirichotiratana N, Satitvipawee P, Sompopcharoen M, Viwatwongkasem C, et al. The impact of cigarette plain packaging on health warning salience and perceptions: implications for public health policy. Asia Pac J Public Health. 2015;27(8):848–59.CrossRef
27.
The Union. The Union Asia Pacific Region in 2016: Increase in Graphic Health Warnings on Tobacco Packs 2016.
28.
Omar M, Damayanti R, Vanphanom M. Regional efficacy testing graphic health warnings in Asean countries of Cambodia, Indonesia, Lao PDR, Malaysia, Philippines, Thailand, And Vietnam. 2008.
29.
Popova L, Ling PM. Nonsmokers’ responses to new warning labels on smokeless tobacco and electronic cigarettes: an experimental study. BMC Public Health. 2014;14(1):997.CrossRef
30.
Noar SM, Hall MG, Francis DB, Ribisl KM, Pepper JK, Brewer NT. Pictorial cigarette pack warnings: a meta-analysis of experimental studies. Tob Control. 2016;25(3):341.CrossRef
31.
Hoek J, Gendall P, Louviere J. Rationalisation as delusion: pictorial health warnings and tobacco industry arguments. J Consum Mark. 2011;28(7):476–83.CrossRef
32.
Mead EL, Cohen JE, Kennedy CE, Gallo J, Latkin CA. The influence of graphic warning labels on efficacy beliefs and risk perceptions: a qualitative study with low-income, urban smokers. Tob Induc Dis. 2016;14:25.CrossRef
33.
Thrasher JF, Abad-Vivero EN, Huang L, O'Connor RJ, Hammond D, Bansal-Travers M, et al. Interpersonal communication about pictorial health warnings on cigarette packages: policy-related influences and relationships with smoking cessation attempts. Soc Sci Med. 2016;164:141–9.CrossRef
34.
35.
36.
Metadata
Title
Perceived effectiveness of pictorial health warnings on changes in smoking behaviour in Asia: a literature review
Authors
Suci Puspita Ratih
Dewi Susanna
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-6072-7

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

Follow-up of a healthy lifestyle education program (the EdAl study): four years after cessation of randomized controlled trial intervention

Research article

Contextualising health screening risk assessments in police custody suites – qualitative evaluation from the HELP-PC study in London, UK

Study protocol

HealthLit4Kids study protocol; crossing boundaries for positive health literacy outcomes

Study protocol

Motivational interviewing in long-term sickness absence: study protocol of a randomized controlled trial followed by qualitative and economic studies

Research article

Sexual risk among Colombian adolescents: knowledge, attitudes, normative beliefs, perceived control, intention, and sexual behavior

Research article

Impact of maternal ART on mother-to-child transmission (MTCT) of HIV at six weeks postpartum in Rwanda