Yahya Nurul Asyikin, Mohamed Kutty Nur Aqilah, Saleh Nurul Afira
Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia.
Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia.
PeerJ. 2024 Dec 18;12:e18713. doi: 10.7717/peerj.18713. eCollection 2024.
In 2003, the World Health Organization (WHO) recommended that pictorial warnings on tobacco products be used to educate consumers on the negative health impacts associated with tobacco use. This study aimed to assess the effectiveness of pictorial warnings on cigarette packaging among smokers and non-smokers.
A cross-sectional study using a self-administered questionnaire was conducted in Kuala Lumpur. Four components assessed the respondents' socio-demographics, smoking status, perceptions, and impact of pictorial warnings. Six standard cigarette pictorial warning images were included in the questionnaire. Data collected were analysed using SPSS version 29.0. Frequencies and percentages were used for categorical data, while means and standard deviations were used for continuous data. Statistically significant results were set at -value < 0.05. Non-parametric tests, the Chi-square test and the One-Way ANOVA test were used to calculate the differences between the variables, as the data was not normally distributed.
Three hundred seventy-eight respondents participated in this study, with smokers and non-smokers divided equally, 189. Most respondents were 20-29 years old ( = 223, 59.0%) and had tertiary education ( = 207, 54.8%). Most smokers were male ( = 172, 91.0%), and most non-smokers were female ( = 119, 63.0%). Most respondents ( = 364, 96.3%, = 0.276) noticed the pictorial warnings on cigarette packs. Nevertheless, significantly ( < 0.001) more smokers ( = 73, 38.6%) seldomly read the content compared to non-smokers ( = 57, 30.2%). Most smokers ( = 48, 12.7%) sometimes consider quitting smoking upon exposure to pictorial warnings on cigarette packs. However, most non-smokers ( = 161, 42.6%) never had the urge to smoke upon looking at the pictorial warnings. The most impactful image on cigarette packs among smokers was 'Lung cancer' ( = 74, 39.2%), while for non-smokers was 'Mouth cancer' ( = 59, 31.2%) with < 0.001.
While non-smokers demonstrated greater engagement with and emotional responses to the warnings, smokers showed less frequent interaction and a tendency toward desensitisation. Although pictorial warnings play a vital role in raising awareness of the health risks of smoking, particularly lung and mouth cancer, their effectiveness in encouraging smoking cessation among smokers remains limited.
2003年，世界卫生组织（WHO）建议在烟草制品上使用图片警示，以教育消费者了解与烟草使用相关的负面健康影响。本研究旨在评估香烟包装上的图片警示对吸烟者和非吸烟者的有效性。
在吉隆坡进行了一项使用自填式问卷的横断面研究。四个部分评估了受访者的社会人口统计学特征、吸烟状况、认知以及图片警示的影响。问卷中包含了六张标准的香烟图片警示图像。收集到的数据使用SPSS 29.0版本进行分析。分类数据使用频率和百分比表示，连续数据使用均值和标准差表示。统计学显著结果设定为p值<0.05。由于数据非正态分布，使用非参数检验、卡方检验和单因素方差分析来计算变量之间的差异。
378名受访者参与了本研究，吸烟者和非吸烟者各189名，人数相等。大多数受访者年龄在20 - 29岁之间（n = 223，59.0%），拥有高等教育学历（n = 207，54.8%）。大多数吸烟者为男性（n = 172，91.0%），大多数非吸烟者为女性（n = 119，63.0%）。大多数受访者（n = 364，96.3%，p = 0.276）注意到了香烟包装上的图片警示。然而，与非吸烟者（n = 57，30.2%）相比，吸烟者中很少阅读警示内容的比例显著更高（p < 0.001）（n = 73，38.6%）。大多数吸烟者（n = 48，12.7%）在看到香烟包装上的图片警示后有时会考虑戒烟。然而，大多数非吸烟者（n = 161，42.6%）在看到图片警示后从未有过吸烟的冲动。吸烟者中对香烟包装影响最大的图片是“肺癌”（n = 74，39.2%），而非吸烟者中是“口腔癌”（n = 59，31.2%），p < 0.001。
虽然非吸烟者对警示的参与度更高且情感反应更强烈，但吸烟者与警示的互动较少且有脱敏倾向。尽管图片警示在提高对吸烟健康风险（特别是肺癌和口腔癌）的认识方面发挥了重要作用，但其在鼓励吸烟者戒烟方面的有效性仍然有限。
