Research paper
Effectiveness of pictorial health warnings on cigarette packs among Lebanese school and university students Hala Alaouie,1 Rema A Afifi,1 Pascale Haddad,1 Ziyad Mahfoud,2 Rima Nakkash1 ▸ Additional material is published online only. To view please visit the journal online (http://dx.doi.org/10.1136/ tobaccocontrol-2012-050745). 1
Faculty of Health Sciences, Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon 2 Department of Global and Public Health, Weill Cornell Medical College, Doha, Qatar Corresponding to Dr Rima T Nakkash, Department of Health Promotion and Community Health, American University of Beirut, Riad El Soloh, PO Box 11-0236, Beirut 1107 2020, Lebanon;
[email protected] Received 27 August 2012 Accepted 23 July 2013 Published Online First 12 August 2013
To cite: Alaouie H, Afifi RA, Haddad P, et al. Tob Control 2015;24:e72–e80. e72
ABSTRACT Background Pictorial health warnings are more effective than text warnings in enhancing motivation to quit and not to start smoking among youth. In Lebanon, packs still have only a very small text warning. The aim of this study was to evaluate the perceived effectiveness of pictorial health warnings on cigarette packs among Lebanese youth. Methods This was a cross-sectional study including school students (n=1412) aged 13–18 years recruited from 28 schools and university students (n=1217) aged 18–25 years recruited from 7 universities. A variety of warnings were adapted from other countries. In all, 4 warnings were tested among school students and 18 among university students. Results All pictorial warnings were considered more effective than the current text warning on messagerelated and impact-related variables, including intentions to quit or not to start smoking among school and university students. Selected examples related to the topranked pictorial warnings are: among male non-smoking school students, 81% agreed that the ‘lung’ warning had more impact on their intentions not to start smoking as compared to 57% for the current text warning ( p