Rana Kirtan, Verma Madhur, Lal Pranay
Department of Community Medicine, Government Medical College and Hospital-32, Chandigarh, India.
Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India.
Glob Health Promot. 2024 Sep 19:17579759241270914. doi: 10.1177/17579759241270914.
Health warning labels (HWLs) are one of the key strategies for tobacco control. The current study assessed the individual characteristics affecting the noticeability of HWLs and the thought of quitting smokeless tobacco (SLT) on noticing HWLs. We further estimated the temporal changes in noticeability and thought of quitting after noticing HWLs over time in India.
Data from two rounds (2009-2010 and 2016-2017) of GATS (Global Adult Tobacco Survey) from India were analysed to understand the pattern of SLT usage and estimate the relative changes in the noticeability of HWLs and the thought of quitting SLT among those who noticed HWLs. Sampling weights were used during the analysis. Multivariate binary logistic regression was used to explore the determinants for the noticeability of HWLs and encourage the intention to quit SLT after noticing the HWLs.
About 25.9% and 20.6% of participants consumed SLT daily or non-daily in two rounds of GATS. Overall, there was a 14% relative increase in noticing the HWLs and a 20% increase in the thought of quitting in GATS-2 compared with GATS-1. The adjusted odds ratio of observing HWLs among SLT users was 1.51 times (95% confidence interval (CI), 1.44-1.58) in round 2 compared with round 1, while the odds ratio concerning the thought of quitting SLT after noticing HWLs was 1.95 times (95% CI, 1.84-2.06) in round 2 compared with round 1.
We observe a consistent increase in the noticeability of HWLs and intentions to quit in SLT users, with significant variations across socio-demographic characteristics calling for concerted efforts. SLT being the major form of tobacco usage in India and Asian countries, HWLs alone cannot bring down the consumption rates, and it needs to be supported by strict implementation of SLT legislation for long-lasting impact.
健康警示标签是烟草控制的关键策略之一。本研究评估了影响健康警示标签关注度的个体特征，以及看到健康警示标签后戒烟的想法。我们还进一步估计了印度一段时间内健康警示标签关注度的时间变化以及看到健康警示标签后戒烟想法的变化。
分析来自印度两轮（2009 - 2010年和2016 - 2017年）全球成人烟草调查（GATS）的数据，以了解无烟烟草（SLT）的使用模式，并估计健康警示标签关注度的相对变化以及看到健康警示标签的人戒烟的想法。分析过程中使用了抽样权重。采用多变量二元逻辑回归来探讨健康警示标签关注度的决定因素，并鼓励看到健康警示标签后戒烟的意愿。
在两轮GATS中，分别有25.9%和20.6%的参与者每天或非每天使用无烟烟草。总体而言，与GATS - 1相比，GATS - 2中健康警示标签的关注度相对增加了14%，戒烟想法增加了20%。与第一轮相比，第二轮中无烟烟草使用者看到健康警示标签的调整后比值比为1.51倍（95%置信区间（CI），1.44 - 1.58），而看到健康警示标签后戒烟想法的比值比在第二轮中为1.95倍（95%CI，1.84 - 2.06）。
我们观察到无烟烟草使用者对健康警示标签的关注度和戒烟意愿持续增加，不同社会人口特征存在显著差异，需要共同努力。无烟烟草是印度和亚洲国家烟草使用的主要形式，仅靠健康警示标签无法降低消费率，需要严格实施无烟烟草立法以产生持久影响。
