Prevalence of Smoking and Impact of Pictorial Health Warning on Quit Attempts Among Youths in Bhaktapur, Nepal

Background: Nepal for the first time implemented laws regarding the pictorial health warnings in April 2014 regardless of an unsuccessful challenge that was set up by the tobacco industry in 2011. Results from several studies have shown that health warnings on cigarette packages have been helpful in warning smokers as well as nonsmokers regarding the harms of cigarette smoking, encouraging smokers to quit and also preventing nonsmokers from starting to smoke. Aim: The objective of this study was to find the impact of pictorial health warning on quit attempts. Methods: An explanatory cross-sectional study was conducted among youths aged 15-24 years in Suryabinayak-5, Bhaktapur with probability systematic random sampling technique using self-administered questionnaire. Results: Half (50%) of the respondents first tried smoking at the age of 16 or older. Seventeen percent of the respondents smoked cigarettes either occasionally or regularly during the past 30 days. Most of the respondents (91%) have not tried smokeless tobacco products ever in their life. Sixty-seven percent of the respondents had noticed PHW on cigarette packages during the past 30 days. One fourth (21.8%) respondents made an quit attempt due to PHW during the past 12 months and their maximum duration of abstinence during the last quit attempt was more than a week but less than a month. From the study it is found that there is statistically significant association between noticing pictorial health warning and thought about quitting smoking or intention about not starting smoking. Conclusion: Pictorial warnings effectively increased peoples quitting intentions, attempts as well as relinquishing cigarettes. Our findings suggest that implementing 90% pictorial health warnings on cigarette packs in Nepal would discourage smoking.