The effects of health warning labels on cigarette packages on patients who apply to cardiology clinic

Ercan Akşit; Çoşkun Bakar; Özgür Özerdoğan; Özge Turgay Yıldırım; Fatih Aydın; Ayşe Hüseyinoğlu Aydın; Bahadır Kırılmaz; Emine Gazi; Ali Duygu

doi:10.28982/josam.435234

Authors

Ercan Akşit https://orcid.org/0000-0002-4478-4324
Çoşkun Bakar
Özgür Özerdoğan
Özge Turgay Yıldırım
Fatih Aydın
Ayşe Hüseyinoğlu Aydın
Bahadır Kırılmaz
Emine Gazi
Ali Duygu

DOI:

https://doi.org/10.28982/josam.435234

Keywords:

Health warning labels, Cigarette smoking

Abstract

Aim: Health warning labels (HWLs) on cigarette packages, which describe the health problems that may be caused by smoking, have been used struggle against smoking for many years. There are no studies in Turkey that investigate how HWLs used abroad have an impact on the population, and especially on patients who apply to cardiology clinic. In this study, we investigated the effect of HWLs on patients who apply to cardiology clinic and compared the HWLs used in our country with those used abroad which we considered to be harsh and striking.

Methods: In this descriptive study, a questionnaire consisting of 45 questions was administered to 239 patients who applied to cardiology clinic. 14 different visuals used in our country and 9 different visuals used in foreign countries were compared.

Results: In our study, 28.9% of the participants who applied to cardiology clinic have never smoked, 36.0% of them still smoked and 35.1% of them were ex-smokers. 57.7% of the survey participants stated that the HWLs on cigarette packages were effective and 90.8% of the participants stated that warnings in foreign countries were more effective than the ones in Turkey.

Conclusion: This study shows that even among patients who apply to cardiology clinic, smoking is still common. When compared to the HWLs used in our country, the ones used abroad were found to be more effective by the majority of the participants. The use of harsher and more striking HWLs seem to be more effective to struggle against smoking.

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References

Warren CW, Jones NR, Peruga A, Chauvin J, Baptiste JP, Costa de Silva V, et al. Global youth tobacco surveillance, 2000-2007. MMWR Surveill Summ. 2008;57:1-28.

World Health Organization Geneva: WHO report on the Global Tobacco Epidemic, the MPOWER package. (ISBN 978 92 4 159628 2) 2008 Jun (cited 2017 December 2): 1(1): (24 screens) Available from URL: http://apps.who.int/iris/bitstream/10665/43818/1/9789241596282_eng.pdf.

Public Health Institution of Turkey. Global Adult Tobacco Survey Turkey 2012. (ISBN 978-975-590-502-0) 2012 Dec (cited 2017 July 21): 1(1): (29 screens) Available from URL: http://www.halksagligiens.hacettepe.edu.tr/english/GATS_english.pdf.

TC. Ministry of Health, Refik Saydam Hıfzıssıhha Center Presidency Hıfzıssıhha School Directorate, Başkent University. National Burden of Disease and Cost Effectiveness Project. Disease Burden Final Report. Ankara, 2004 Dec (cited 2017 March 5): 1(1): (207 screens). Available from: URL: http://www.toraks.org.tr/userfiles/file/ulusal_hastalik_yuku_hastalikyukuTR.pdf.

Ergüder T. Framework Convention on Tobacco Control, Global Action for Global Health (The WHO Framework Convention on Tobacco Control). Ankara, (ISBN:978-975-590-247-0) 2008 Feb (cited 2017 July 5): 1(1): (9 screens). Available from: URL: https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/t20.pdf.

Moodie C, Hastings G. Tobacco packaging as promotion. Tobacco Control. 2010;19:168–70.

Centers for Disease Control and Prevention. Cigarette package health warnings and interest in quitting smoking - 14 countries, 2008–2010.MMWR Morbidity & Mortality Weekly Report. 2011;60(20):645–51.

Durkin S, Brennan E, Wakefield MA. Mass media campaigns to promote smoking cessation among adults: An integrative review. Tobacco Control. 2012;21:127–38.

T. C. Official Newspaper. Regulation on Procedures and Principles for Production Shape, Labeling and Inspection for the Protection of Tobacco Products from Harms. Jan 6, 2005. Available from: URL: http://www.resmigazete.gov.tr/eskiler/2005/01/20050106-14.htm.

T. C. Official Newspaper. Regulation on Procedures and Principles for Production Shape, Labeling and Inspection for the Protection of Tobacco Products from Harms. Feb 27, 2010 Available from: URL: http://www.resmigazete.gov.tr/eskiler/2010/02/20100227-8.htm.

Bansal Travers M, Hammond D, Smith P, Cummings KM. The impact of cigarette pack design, descriptors, and warning labels on risk perception in the US. Am J Prev Med. 2011;40(6):674-82.

Zhao X, Nan X, Yang B, Iles IA. Cigarette warning labels: graphics, framing, and identity. Health Education. 2014;114(2):101-17.

Goodall C, Appiah O. Adolescents' perceptions of Canadian cigarette package warning labels: investigating the effects of message framing. Health Commun. 2008;23(2):117-27.

Inoue-Choi M, Hartge P, Liao LM, Hartge P, Caporaso N, Freedman ND. Association between long-term low-intensity cigarette smoking and incidence of smoking-related cancer in the national institutes of health-AARP cohort. Int J Cancer. 2018;142:271.

Tobacco Labelling Research Center. Available from: URL: http://www.tobaccolabels.ca/healthwarningimages/.

World Health Organization. Global Status Report on Noncommunicable Diseases. WHO (ISBN 978 92 4 156485 4 2014) 2014 Jun (cited 2017 June 1): 1(1): (232 screens). Available from: URL: http://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf?ua=1.

Kang E. Assessing Health Impacts of Pictorial Health Warning Labels on Cigarette Packs in Korea Using DYNAMO-HIA. J Prev Med Public Health. 2017;50:251-61.

Strahan EJ, White K, Fong GT, Fabrigar LR, Zanna MP, Cameron R. Enhancing the effectiveness of tobacco package warning labels: a social psychological perspective. Tob Control. 2002;11:183-90.

Environics Research Group. Wave 9 Surveys. The Health Effects of Tobacco and Health Warning Messages on Cigarette Packages: Survey of Adults and Adults Smokers. Toronto, Environics Research Group Limited, 2005 (cited 2017 June 10): 1(1): (29 screens). Available from: URL: http://www.tobaccolabels.ca/wp/wp-content/uploads/2013/12/Canada-2005-The-Health-Effects-of-Tobacco-and-Health-Warning-Messages-on-Cigarette-Packages-A-Survey-of-Adults-and-Adult-Smokers-Government-report.pdf.

Ratneswaran C, Chisnall B, Drakatos P, Sivakumar S, Sivakunar B, Barrecheguren M, et al. A cross-sectional survey investigating the desensitization of graphic health warning labels and their impact on smokers, non-smokers and patients with COPD in a London cohort. BMJ Open. 2014;4:e004782.

Ratneswaran C, Chisnall B, Li M, Tan S, Douiri A, Anantham D, et al. Desensitization to cigarette package graphic health warnings: a cohort comparison between London and Singapore. BMJ Open. 2016;6:e012693.

White V, Bariola E, Faulkner A, Coomber K, Wakefield M. Graphic health warnings on cigarette packs: how long before the effects on adolescents wear out? Nicotine Tob Res. 2015;17:776–83.

Borland R, Wilson N, Fong GT, Hammond D, Cummings KM, Yong HH, et al. Impact of graphic and text warnings on cigarette packs: findings from four countries over five years. Tob Control. 2009;18:358–64.

Hammond D, Fong GT, Borland R, Cummings KM, McNeill A, Driezen P. Text and graphic warnings on cigarette packages: findings from the international tobacco control four country study. Am J Prev Med. 2007;32:202–9.

Tversky A, Kahneman D. Availability: a heuristic for judging frequency and probability. Cogn Psychol. 1973;5:207–32.

Wyer RS Jr, Hartwick J. The role of information retrieval and conditional inference processes in belief formation and change. Adv Exp Soc Psychol. 1980;13:241–84.

Strahan EJ, White K, Fong GT, Fabrigar LR, Zanna MP, Cameron R. Enhancing the effectiveness of tobacco package warning labels: a social psychological perspective. Tob Control. 2002;11:183-90.

Steptoe A, Wardle J, Smith H, Kopp M, Skrabski A, Vinck J, et al. Tobacco smoking in young adults from 21 European countries: Association with attitudes and risk awareness. Addiction. 1995;90:571–82.

Bidwell G, Sahu A, Edwards R, Harrison RA, Thornton J, Kelly SP. Perceptions of blindness related to smoking: a hospital-based cross-sectional study. Eye. 2005;19:945–8.