Does 85% pictorial health warning on the tobacco products have the impact among tobacco users in India?

Abstract

Background After persistent civil society and judicial interventions, 85% Pictorial Health Warning (PHW) was implemented in India since April, 2016. The previous 40% PHW had negligible impact in preventing new users and motivating existing users to quit tobacco. The current PHW printed on smoking products is picture of a throat cancer and on smokeless tobacco products is cancer of oral cavity and this should cover 85% of the outer panel of the tobacco products. Text message as "Smoking causes cancer, Smoking kills" also printed on the packs. The present study aimed at understanding the impact of 85% PHW on motivating tobacco users to quit. Methods Tobacco users (n=99) were chosen by convenient sampling from Chennai, Tamil Nadu. One cigarette packet and one chewing tobacco packet printed with 85% PHW was shown to them and interviewed using a semi structured questionnaire. The questions included were, their current tobacco use, comprehension of text and PHWs printed on tobacco products and its ability to motivate the users to quit. Results Majority of the tobacco users (84.8%) noticed the health warnings on tobacco products (PHW-13.1%, Text warning-14.1%, Both-57.5%). Overall 67.6% tobacco users(Smoking-46.4%, smokeless-21.2%) were able to identify the picture correctly and 55.5% related the picture to health problems. A few users (8%) couldn't read the text warning since it was printed in English. The understanding is better if they could read the text warning also. The 52.5% of the users reported that the PHW made them to think about quitting and 72.7% reported that PHW will motivate the users to quit. The users (38.3%) reported total ban as the best measure for tobacco control. Conclusions The 85% PHW has positive impact in motivating the tobacco users to quit. However, printing the text warning in regional language will be effective for the people who cannot read English