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ObjectiveTo evaluate the warning effect of different tobacco packaging on teenagers and provide an objective evidence for improving tobacco packaging in China. MethodsA multi-stage cluster sampling method was used to investigate students from two middle schools and two high schools in Huangpu District， Shanghai with a self-filled questionnaire survey， and a total of 1 238 valid questionnaires were collected. Epidata 3.1 was used to input data and SPSS 20.0 was used for data analysis. ResultsAbout 69% of the respondents supported printing pictures of diseases on tobacco packages in China， and 81.58% thought graphic warnings should cover more than 70% of the tobacco package. The effect of graphic health warning labels was better than that of text-only warning labels （P<0.05）， and the effect of real photos was better than abstract pictures. In addition， labels with real graphic warnings had the highest scores in terms of preventing youth smoking and the degree of support， which was significantly different from abstract graphic warning labels and text-only warning labels （P<0.05）. ConclusionCigarette packs with graphic health warnings have a stronger effect on teenagers than plain text health warnings. Teenagers support the use of graphic warnings. It is recommended to apply graphic health warnings with real photos of diseases on the cigarette packages to maximize the effect of the health warnings.
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@#Introduction: Initially, studies showed that graphic warning signs (GWSs) on cigarette packages encouraged smoking cessation. However, there have been recent concerns over the effectiveness of GWSs to change smoker perceptions and behavior over time. Our goals were to assess the latest perceptions of GWSs among smokers in Kelantan and to determine the factors associated with them. Methods: This cross-sectional study was conducted among respondents who attended outpatient clinics in a teaching hospital in Kelantan. Their perceptions were analyzed with a validated Malay questionnaire containing four domains: fear, influence, credibility, and picture content. Results: The average smoking age was 17 (3.04) years old. The mean smoking time was 11 (7.49) years. The average daily cigarettes smoked was 8 (6.26). Most respondents perceived low levels of fear (83%), poor picture content (65.5%), low influence (87.6%), and low levels of credibility (70.1%) in GWSs. Those with low levels of education were significantly associated with poor perceptions of GWSs. Conclusion: Despite vigorous efforts by the government to discourage smoking in Kelantan, smokers still poorly perceive GWSs. More effective health-promotion strategies are essential to influence smokers in this area.
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BACKGROUND: In an effort to use cigarette warning labels as a means for reducing smoking rates, this study examined current cigarette warning messages and newly designed pictorial warning labels. METHODS: From June 15, 2005, to June 22, 2005 we conducted an e-mail survey of 1,200 civilians to examine the effect of cigarette warning labels. For statistical analysis, we used chi-square test with SPSS 11.0 software. RESULTS: Among all the respondents, 78.7% indicated that current cigarette warning labels did not have any effect. However, most of the respondents indicated that pictorial warning labels are effective in raising public awareness (84.6%) or knowledge (81.5%) of the harmful effects of cigarettes. They also responded that pictorial warning labels would help them quit smoking (75.9%) or keep them from buying cigarettes (64.1%). Over 80% of the respondents and over 70% of the smokers responded that they would welcome the use of pictorial warning labels as an anti-smoking measure. CONCLUSION: The results of this study showed that current cigarette warning labels are not effective in curbing smoking rates. Also, the results suggest that current cigarette warning labels need to be improved if they are to be used as an effective anti-smoking measure.