Dissuasive cigarettes as a tobacco control measure: a scoping review

Cigarette packaging as a commercial determinant of smoking: A thematic analysis of Filipinos' perception of graphic health warnings and plain packaging in the Philippines

In line with recommendations of Article 11 of the WHO Framework Convention on Tobacco Control, the Philippines has implemented graphic health warnings (GHWs) on cigarette packs. While the Graphic Health Warnings Law was passed in 2014, it was only implemented in 2016. Using a commercial determinants of health framework, this study aims to contribute evidence on Filipinos' perceptions of GHWs and the potential plain packaging of tobacco products in the Philippines. We used a dataset based on open-ended questions in online and nationwide household surveys from 2021. Data collectors showed mock-up sets of cigarette packs based on the Philippines' law on GHWs and Thailand's and Singapore's plain packaging to respondents to gather their comments on each pack's features and its GHW. We conducted a thematic analysis to extract themes in respondents' perceptions. We gathered 3,723 responses from online and household surveys. Most respondents commented on the Philippine packs' ineffectiveness and lauded GHWs from Singapore and Thailand for their characteristics and the information in the warnings, remarking that valuable features of Singapore and Thailand's plain packs for making current cigarette packaging more effective were larger GHWs, less brand visibility, and quitline availability. The study supports recent literature assessing local GHWs. Current GHWs are seen as ineffective, highlighting the need for policy reform. Policymakers should consider prohibiting single-stick cigarette sales, adopting plain packaging with larger GHWs to decrease brand visibility, and increasing the visibility and accessibility of quitlines to motivate smokers to quit and discourage Filipinos from smoking.

Perceptions of health warnings on cigarette sticks among the adult population in Al-Madinah, Saudi Arabia: A cross-sectional survey

INTRODUCTION

Health warnings on cigarette sticks are emerging as a tool to control tobacco consumption; hence, understanding how they are perceived is valuable in determining their effectiveness. Our study aimed to evaluate the perception of health-related messages and warnings on individual cigarette sticks. It also aimed to evaluate the perceptions of the effectiveness of cigarette packaging warnings and the acceptance level for the inclusion of health warnings on cigarette sticks.

METHODS

This cross-sectional survey was conducted on 285 individuals in Al-Madinah, Saudi Arabia. The survey was distributed online using a non-probability convenience sampling technique. The chi-squared test and logistic regression analysis were used to determine the association of sociodemographic characteristics and smoking-related variables with participants' perceptions of health warnings on cigarette sticks and packaging. The responses were also assessed qualitatively using conceptual content analysis.

RESULTS

In all, 18.6% of participants perceived that the package warnings were either 'quite effective' or 'very effective' in prompting smokers to quit. For health warnings on cigarette sticks, 28.1% of participants perceived that the theme of statistics on mortality was either 'quite effective' or 'very effective' in prompting smokers to quit, compared to 35.0 % for the theme of social and financial consequences. Respondents who had secondary education and lower were almost two times more likely to support the inclusion of health warnings than those who had a university education and higher (OR=1.9; 95% CI: 1.02-3.7, p=0.042). Most of the comments were positive for the inclusion of health warnings on cigarette sticks.

CONCLUSIONS

Most participants perceived that package warnings were ineffective, but warnings on cigarette sticks were effective methods of dissuasion of cigarette use. Smokers were almost twice as likely to perceive as effective supportive messages to quit than non-smokers. The majority of participants 'agreed' or 'strongly agreed' to the inclusion of health warnings on cigarette sticks.