Mikail Özdemir, Seda Beyhan Sağmen

Evaluation of the relationship between perception of tobacco packaging pictorial warnings and the nicotine addiction levels of smokers who admitted to smoking cessation clinic in Malatya, Turkey

Objective: In this study, we aimed to investigate relationship between perception of tobacco packaging pictorialwarnings and the nicotine addiction levels of smokers who admitted to smoking cessation clinic in Malatya,Turkey.Methods: Three hundred fifty-six patients were enrolled from the Malatya State Hospital Smoking CessationClinic. The characteristics of the patients, and number of cigarettes smoked were evaluated. The Fagerströmtest for nicotine dependence was used. Fourteen of the best-known and most effective pictorial health warningson cigarette packages were shown and evaluated.Results: The two best-known pictorial warnings in both male and female participants were pictorial 6, “Smokecontains benzene, nitrosamines, formaldehyde, and hydrogen cyanide” and pictorial 7, “Smoking causes fatallung cancer”. The third best-known pictorial warning for female was pictorial 4, “Smokers die younger,” andfor male it was pictorial 1, “Smoking may reduce blood flow and causes impotence”. Female were most affectedby pictorial 11, “Protect children; don’t make them breathe your smoke’’, and male were most affectedbypictorial 1, “Smoking may reduce blood flow and causes impotence” (p < 0.043 and p = 0.01, respectively).Fagerström scores compared with pictures mostly known and affected by participants, the highest and lowestscores belongs to same pictures; the highest Fagerström score was 8.29 ± 2.14 for best known and 8.25 ± 2.19for most affected picture is number 2; the lowest Fagerström score was 6.46 ± 2.55 for best known and 6.56 ±2.68 for most affected picture is number 3.Conclusion: The effect of pictures about the decision to quit smoking may be investigated by a qualitativestudy especially for pictures 1, 2, 4, 6, 7, and 11.

PDF

___

[1] Bala MM, Strzeszynski L, Topor-Madry R, Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database Syst Rev 2013;6:CD004704.
[2] Mackay J, Eriksen M, Shafey O. The Tobacco Atlas. 2nd ed. Brighton, UK: American Cancer Society, 2006.
[3] US Department of Healthand Human Services. Preventing tobacco use among young people: a report of theSurgeon General. US.
[4] Hammond D, Fong GT, Borland R, Cummings KM, McNeill A, Driezen P. Communicating risk to smokers: the impact of health warnings on cigarette packages. Am J Prev Med 2007;32:202-9.
[5] Tütün Ürünlerinin Zararlarının Önlenmesi Ve Kontrolü Hakkında Kanun. http://www.mevzuat.gov.tr/Kanunlar.aspx [Erişim Tarihi: 07.10.2012].
[6] Buzgan T, Çom S, Irmak H, Baykan H, Aydın E, Taner S. MPOWER: Tütün Salgınını Kontrol Etmeye Yönelik Politika Paketi, Sağlık Bakanlığı, Ankara, 2011.
[7] WHO Framework Convention on Tobacco Control, World Health Organization 2003, Geneva.
[8] WHO Report on the Global Tobacco Epidemic, The MPOWER Package, WHO, Geneva, 2008.
[9] Bilir N, Kaplan B, Küçük Biçer B, Ararat E, Akyol M, Arslan A, et al. [Opinions of a group of high school students in Ankara on pictorial warnings on cigarette packages]. Turk Toraks Derg 2013;14:127-33. [Article in Turkish]
[10] Vardavas CI, Connolly G, Karamanolis K, Kafatos A. Adolescents perceived effectiveness of the proposed European graphic tobacco warning labels. Eur J Public Health 2009;19:212-7.
[11] Bayrak B, Bilir N, Yardım MS, Gürkan H, Karakullukçuoğlu Z, Kaya A. [Opinions of a group of high school students about the possible impact of combined warnings to be depicted on the cigarette packages]. Turk Toraks Derg 2010;11:1-9. [Article in Turkish]
[12] Hammond D. Health warning messages on tobacco products: a review. Tob Control. 2011;20:327-37.
[13] Thrasher JF, Perez-Hernandez R, Arillo-Santillan E, BarrientosGutierrez I. [Towards informed tobacco consumption in Mexico: effect of pictorial warning labels in smokers]. Salud Publica Mex 2012;54:242- 53. [Article in Spanish]
[14] Önsüz MF, Topuzoğlu A, Algan A, Soydemir E, Aslan İ. [Evaluatıon of the relationship between perception of tobacco packaging warning messages and the nicotine addiction levels of smoker]. Marmara Med J 2009;22;111-22. [Article in Turkish]