RESEARCH PAPER
Perceived effectiveness of graphic health warnings as a deterrent for smoking initiation among adolescents in selected schools in southwest Nigeria
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1
Department of Preventive Medicine and Primary Care, University of Ibadan, Ibadan, Nigeria
2
Department of Community Medicine, University College Hospital, Ibadan, Nigeria
3
College of Medicine, University of Ibadan, Ibadan, Nigeria
Submission date: 2015-05-22
Acceptance date: 2016-03-16
Publication date: 2016-03-18
Corresponding author
A. O. Adebiyi
Department of Preventive Medicine and Primary Care, University of Ibadan, Ibadan, Nigeria
Tobacco Induced Diseases 2016;14(March):7
KEYWORDS
ABSTRACT
Background:
There has been a sustained increment in young people initiating smoking in low middle income countries like Nigeria. Health warnings on cigarette packages are a prominent source of health information and an effective means of communicating specific disease risks to adolescents and young adults alike. This study evaluated the perceived effectiveness of selected graphic warnings on smoking initiation amongst in-school adolescents.
Methods:
This was a cross-sectional study conducted amongst secondary school students aged 13–17years in Igbo-Ora, Nigeria. A two-stage sampling technique with the school classes as the final sampling unit was used to select the students. An interviewer assisted questionnaire was used to obtain information on students demographic characteristics and their perception of graphic warnings using four images from the pictorial health warning galleries of the World Health Organization showing: ‘cigarette smoking causes cancer of the airways, harms children, causes stroke and causes impotence respectively'.
Results:
A total of 544 senior secondary students were included in this study with a male female ratio of 0.8:1. Of those interviewed, 40 (7.4 %) indicated that they had ever considered smoking, nine (1.7 %) responded that they had ever smoked and two students indicated that they were current smokers.
With all the images, fear was the dominant emotion expressed by the respondents. This was expressed by 307 (56.4), 215 (39.5), 203 (37.3) and 228 (41.9 %) respondents to images 1, 2, 3, and 4 respectively. Furthermore, 76.7, 44.7, 58.5 and 62.1 % of respondents felt Images 1, 2, 3 and 4 respectively will to a large extent prevent people from initiating smoking. There was no association between perceived effectiveness and gender. However, those younger than 15 years rated images on cancer of the airway and impotence as probably effective to a larger extent than did those who were 15 years and older (p = 0.032).
Conclusions:
Introduction of graphic health warnings, especially with an imagery depicting cancer and impotence may influence non-smokers to remain abstinent. Therefore, this study provides a template for a future policy-relevant study on graphic health warning in Nigeria.
REFERENCES (20)
1.
Eriksen M, Mackay J, Ross H. The Tobacco Atlas. Fourthth ed. Atlanta, GA: American Cancer Society, and New York, NY: World Lung Foundation; 2012.
2.
Jha P, Chaloupka FJ. Tobacco control in developing countries. Oxford: University Publication for the World Bank and the World Health Organization; 2000.
3.
Odeyemi KA, Osibogun A, Akinsete AO, Sadiq L. The prevalence and predictors of cigarette smoking among secondary school students in Nigeria. Niger Postgrad Med J. 2009;16(1):40–5.
5.
Odukoya OO, Odeyemi KA, Oyeyemi AS, Upadhyay RP. Determinants of smoking initiation and susceptibility to future smoking among school-going adolescents in Lagos State, Nigeria. Asian Pac J Cancer Prev. 2013;14(3):1747–53.
6.
Hammond D, Fong GT, McNeill A, Borland R, Cummings KM. Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006;15(Suppl III):iii19–25.
7.
World Health Organization. WHO Framework Convention on Tobacco Control (Packaging and labelling of tobacco products). Geneva: World Health Organization; 2008. Accessed on 12 April 2011from
http://www.who.int/fctc/guidel....
8.
Hammond D. Health warning messages on tobacco products: a review. Tob Control. 2011;20:327e337.
9.
Adebiyi AO, Faseru B, Sangowawa AO, Owoaje ET. Tobacco use amongst out of school adolescents in a local government area in Nigeria. Subst Abuse Treat Prev Policy. 2010;5:24.
10.
Department of Health and Human Services, Food and Drug Administration. Required Warnings for Cigarette Packages and Advertisements. 21 CFR Part 1141 [Docket No. FDA–2010–N–0568]; RIN 0910–AG41. Accessed on 12th June 2013 at www.fda.gov/downloads/…/UCM339834.pd.
12.
Assets Coming Together (ACT) for Youth Upstate Center of Excellence. Stages of adolescent development. Research facts and findings, May 2004. A publication of the ACT for Youth Center of Excellence. Available at:
http://www.actforyouth.net/res.... Accessed August 21, 2014.
13.
Strahan EJ, White K, Fong GT, et al. Enhancing the effectiveness of tobacco package warning labels: a social psychological perspective. Tob Control. 2002;11:183e90.
14.
White V, Webster B, Wakefield M. Do graphic health warning labels have an impact on adolescents’ smoking-related beliefs and behaviours? Addiction. 2008;103(9):1562–71.
15.
Wakefield M, Morley C, Horan JK, Cummings KM. The cigarette pack as image: new evidence from tobacco industry documents. Tob Control. 2002;11 Suppl 1:i73–80.
16.
Fong GT, Hammond D, Hitchman SC. The impact of pictures on the effectiveness of tobacco warnings. Bull World Health Organ. 2009;87(8):640–3. doi:10.2471/BLT.09.069575.
17.
Okpere AN, Anochie IC, Eke FU. Pattern of blood pressure and hypertension in adolescents in Port Harcourt, Nigeria. West Afr J Med. 2013;32(2):93–8.
18.
Ujunwa FA, Ikefuna AN, Nwokocha AR, Chinawa JM. Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria. Ital J Pediatr. 2013;39:70.
19.
Nobelius AM, Kalina B, Pool R, Whitworth J, Chesters J, Power R. Delaying sexual debut amongst out-of-school youth in rural southwest Uganda. Cult Health Sex. 2010;12(6):663–76.
20.
Fong GT, Hammond D, Jiang YA, Li QA, Quah ACK, Driezen P, Yan M. Perceptions of tobacco health warnings in China compared with picture and text-only health warnings from other countries: An experimental study. Tob Control. 2010;19:i69–77.
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7.
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8.
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10.
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11.
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