Iwase Erina, Yamato Hiroshi, Tabuchi Takahiro, Togawa Kayo, Katanoda Kota, Nakamura Masakazu
Graduate School of Medicine, University of Occupational and Environmental Health.
Department of Health Development, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health.
Nihon Koshu Eisei Zasshi. 2025 Jan 9;71(12):756-765. doi: 10.11236/jph.24-009. Epub 2024 Oct 23.
Objectives This study aimed to evaluate Japanese smokers' perceptions of health warnings on tobacco packaging by comparing text-only and pictorial warnings.Methods Data were sourced from the Japan Society and New Tobacco Internet Survey (JASTIS), an online, self-reported study conducted in February and March 2020. Participants included current smokers aged 15-74 years in Japan (n＝2,372). Perceptions regarding five packaging samples were assessed: the old package (text-only warning covering 30% of the pack's front and back before April 2020), the current package (text-only warning covering 50% of the pack's front and back), and three packages with pictorial warnings covering 50% of the front and back. Respondents were asked four questions on a 5-point Likert scale regarding the effectiveness of these warnings in terms of discouraging young people from starting to smoke, encouraging them to quit, communicating the dangers of smoking, and comfort level with the warnings. A t-test was conducted to compare each pair of packages.Results There were no significant differences observed between the "text only 30%" and "text only 50%" packages in terms of preventing young individuals from starting to smoke, encouraging quitting, or communicating the dangers of smoking (P＝0.740-0.987). Conversely, packages with pictorial warnings were perceived as more effective than text-only packages (P＜0.01) in all aspects. A significant difference was observed in the respondents' perceptions of comfort levels with the packages, with the pictorial ones deemed more uncomfortable (P＜0.01).Conclusion The findings indicated that pictorial health warnings are significantly associated with increased awareness of smoking risks, motivation to quit smoking, and prevention of smoking initiation among young people. Accordingly, Japan should consider adopting pictorial health warnings in accordance with the Framework Convention on Tobacco Control.
目的 本研究旨在通过比较纯文字警告和图片警告，评估日本吸烟者对烟草包装上健康警告的认知。
方法 数据来源于日本社会与新烟草互联网调查（JASTIS），这是一项于2020年2月和3月进行的在线自我报告研究。参与者包括日本年龄在15 - 74岁的现吸烟者（n＝2372）。评估了对五个包装样本的认知：旧包装（2020年4月前纯文字警告覆盖烟包正反面的30%）、现行包装（纯文字警告覆盖烟包正反面的50%）以及三个图片警告覆盖烟包正反面50%的包装。就这些警告在劝阻年轻人开始吸烟、鼓励他们戒烟、传达吸烟危害以及对警告的舒适度方面的有效性，以5分李克特量表向受访者询问了四个问题。进行t检验以比较每对包装。
结果 在防止年轻人开始吸烟、鼓励戒烟或传达吸烟危害方面，“纯文字30%”和“纯文字50%”包装之间未观察到显著差异（P＝0.740 - 0.987）。相反，在所有方面，有图片警告的包装被认为比纯文字包装更有效（P＜0.01）。在受访者对包装舒适度的认知方面观察到显著差异，图片包装被认为更不舒服（P＜0.01）。
结论 研究结果表明，图片健康警告与提高年轻人对吸烟风险的认识、戒烟动机以及预防吸烟开始显著相关。因此，日本应考虑根据《烟草控制框架公约》采用图片健康警告。
