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Nicotine & Tobacco Research Advance Access published online on February 26, 2009
Nicotine & Tobacco Research, doi:10.1093/ntr/ntn029
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© The Author 2009. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Smokers' responses toward cigarette pack warning labels in predicting quit intention, stage of change, and self-efficacy

Ahmed I. Fathelrahman, Maizurah Omar, Rahmat Awang, Ron Borland, Geoffrey T. Fong, David Hammond and Zarihah Zain

Ahmed I. Fathelrahman, M.Sc., Clearing House for Tobacco Control, the National Poison Center, Universiti Sains Malaysia, Pulau pinang, Malaysia
Maizurah Omar, Ph.D., Clearing House for Tobacco Control, the National Poison Center, Universiti Sains Malaysia, Pulau pinang, Malaysia
Rahmat Awang, Pharm D, Clearing House for Tobacco Control, the National Poison Center, Universiti Sains Malaysia, Pulau pinang, Malaysia
Ron Borland, Ph.D., Vic Health Centre for Tobacco Control, the Cancer Council Victoria, Carlton, Victoria, Australia
Geoffrey T. Fong, Ph.D., Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
David Hammond, Ph.D., Department of Health Studies & Gerontology, University of Waterloo, Waterloo, Ontario, Canada
Zarihah Zain, MBBS, Unit for Tobacco Control & FCTC, Disease Division, Ministry of Health, Kuala Lumpur, Malaysia

Corresponding Author: Ahmed I. Fathelrahman, M.Sc., Clearing House for Tobacco Control, National Poison Center, Universiti Sains Malaysia, Minden 11800 Pulau Pinang, Malaysia. Telephone: +60-4-657-0099. Fax: +60-4-656-8417. Email: afathelrahman{at}yahoo.com


  Abstract

Introduction: This paper is concerned with the effects of cigarette pack warning labels on quitting intentions. We examined whether different responses among smokers toward cigarette pack warning labels could predict quit intentions and self-efficacy in quitting. Variables studied were "noticing warning labels during last month," "reading or looking closely at warning labels," "avoiding looking at labels during last month," "thinking about health risks of smoking because of the warning labels, "more likely to quit because of the warning labels," and "stopping from having a cigarette when about to smoke one because of the labels."

Methods: A total of 2,006 adult smokers in Malaysia were surveyed in face-to-face interviews using a standardized questionnaire. Of those, 1,919 male smokers were included in the analyses.

Results: The responses "more likely to quit because of the warning labels" and "stopped from having a cigarette when about to smoke one" significantly predicted all stages of change and self-efficacy, independent of the other measures. In addition, thinking about the health risks and reading the warnings more often added extra predictive capacity but only in the early stages of contemplating change.

Discussion: Less intense processing of the information may be important in initiating thoughts, but cognitions about quitting and foregoing cigarettes are the key mechanisms by which warnings stimulate quitting intentions and help smokers feel capable of succeeding. Malaysian smokers appear to respond to warnings in ways comparable with those from developed countries.

Received: September 27, 2007; Accepted: August 15, 2008
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