Aryal Netra Lal, Paudel Binita Kumari, Pokhrel Babu Ram, Acharya Sushila, Bhandari Saraswati, Bhandari Sheetal, Rajbanshi Manish, Dhital Shalik Ram
School of Health Sciences, Purbanchal University, Morang, Nepal.
Research Department, Lumbini Eye Institute, Bhairahawa, Nepal.
PLOS Glob Public Health. 2025 Jul 10;5(7):e0004917. doi: 10.1371/journal.pgph.0004917. eCollection 2025.
Despite the efforts of the Government of Nepal, including the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), including 90% of health risk warnings on tobacco packets, the prevalence rate of tobacco consumption and its mortality and morbidity remain a challenge. This study aimed to explore awareness and perception towards Graphic Health Warning (GHWs), challenges, and opportunities for tobacco control policies among stakeholders in Galyang Municipality of Syjanga district, Nepal.This study employed a qualitative study design among 11 stakeholders of the Galyang municipality. Key Informant Interviews (KII) were conducted using the KII guideline. A purposive sampling technique was used to select study participants. The study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guideline. Thematic analysis was performed for data analysis.Participants, including Mayors, Ward Chairpersons, Health Officials, and community leaders, generally recognized GHWs as effective in raising awareness but noted their limited impact on altering smoking behavior, particularly among dependent smokers. While GHWs were seen as more effective than text warnings, many participants emphasized the need for stronger policy enforcement, including restrictions on tobacco sales and smoking in public places. Cleared, high-contrast images on cigarette packets, comprehensive public awareness programs, and active engagement of political leaders and stakeholders to strengthen tobacco control policies and implementation. This study found that GHWs raise awareness about the harms of tobacco, but their impact on behavior change, particularly among dependent smokers, remains limited. Key challenges include weak enforcement of tobacco control policies, regulatory gaps, and limited government engagement. A multi-sectoral approach with community leaders, political commitment, school-based intervention, stronger local governance, licensed tobacco shops, and enhanced GHWs is vital for effective tobacco control. Effective policy execution and community involvement were highlighted as critical to the success of tobacco control initiatives.
尽管尼泊尔政府做出了努力，包括实施世界卫生组织（WHO）的《烟草控制框架公约》（FCTC），其中包括在烟包上设置90%的健康风险警示，但烟草消费的流行率及其死亡率和发病率仍然是一项挑战。本研究旨在探讨尼泊尔锡扬加区加良市各利益相关者对图形健康警示（GHWs）的认识和看法、烟草控制政策面临的挑战及机遇。本研究对加良市的11名利益相关者采用了定性研究设计。使用关键 informant 访谈（KII）指南进行关键 informant 访谈。采用目的抽样技术选择研究参与者。本研究遵循定性研究报告综合标准（COREQ）指南。对数据分析进行主题分析。参与者包括市长、选区主席、卫生官员和社区领袖，他们普遍认为图形健康警示在提高认识方面有效，但指出其对改变吸烟行为的影响有限，尤其是对依赖吸烟者。虽然图形健康警示被认为比文字警示更有效，但许多参与者强调需要加强政策执行，包括限制烟草销售和公共场所吸烟。香烟包装上清晰、高对比度的图像、全面的公众意识项目以及政治领袖和利益相关者积极参与以加强烟草控制政策及实施。本研究发现，图形健康警示提高了对烟草危害的认识，但其对行为改变的影响，尤其是对依赖吸烟者的影响仍然有限。主要挑战包括烟草控制政策执行不力、监管漏洞以及政府参与有限。采取多部门方法，包括社区领袖、政治承诺、基于学校的干预、更强有力的地方治理、有执照的烟草店以及强化图形健康警示，对于有效控烟至关重要。有效的政策执行和社区参与被强调为控烟举措成功的关键。
