Effects of Graphic Warning Labels (GWL) on the Factors Escalating Smoking Behaviour: An Empirical Study on Pakistani Adult Consumers
DOI:
https://doi.org/10.5281/zenodo.15691503Keywords:
Health Communication, Behavioral Economics, Smoking Behaviour, Consumer PsychologyAbstract
Cigarette smoking remains a substantial public health concern, contributing to millions of This study investigates the influence of Graphic Warning Labels (GWLs) on smoking behavior among adult smokers in Pakistan. The study is addressing the moderating role of GWL effectiveness in the relationships between perceived smoking environment, perceived stress, and smoking addiction. As the method, a quantitative, cross-sectional survey was employed, collecting data from 501 adult smokers aged 18–40 years in Rawalpindi, Pakistan, through convenience sampling. Structural Equation Modelling (SEM) using AMOS was employed to analyze direct and moderating effects. Findings revealed that all three independent variables significantly predict smoking behavior: perceived smoking environment (β = 0.102, p = 0.033), smoking addiction (β = 0.107, p = 0.018), and perceived stress (β = 0.218, p < 0.001). However, moderation analysis indicated that GWL effectiveness did not significantly moderate the relationship between any of the predictors and smoking behavior. Interaction effects were not significant in perceived smoking environment (β = 0.057, p = 0.197), perceived stress (β = -0.037, p = 0.405), and smoking addiction (β = 0.064, p = 0.166). These findings indicate that although there is evidence that increases awareness, the level of implementation of GWLs in Pakistan is not sufficient to change smoking behaviour where there are high levels of addiction, stress, and social exposure. A more comprehensive tobacco control program with plain packaging, public education, and cessation assistance is suggested to provide a deterrent effect to GWLs.References
Hiilamo, H., & Glantz, S. A. (2015). Implementation of effective cigarette health warning labels among low and middle income countries: State capacity, path-dependency and tobacco industry activity. Soc Sci Med, 124, 241–245. [CrossRef] [PubMed]
World Health Organization. (2015). WHO report on the global tobacco epidemic, 2015: Raising taxes on tobacco. World Health Organization. [CrossRef]
Yaqub, F. (2015). Pakistan government faces legal challenge over images on tobacco packaging. Lancet Respir Med, 3(9), 673. [CrossRef] [PubMed]
Riley, D. (2014). Mental models in warnings message design: A review and two case studies. Saf Sci. 2014;61:11–20. [CrossRef]
Islami, F., Stoklosa, M., Drope, J., & Jemal, A. (2015). Global and regional patterns of tobacco smoking and tobacco control policies. Eur Urol Focus, 1(1), 3–16. [CrossRef] [PubMed]
Nagelhout, G. E., Osman, A., Yong, H. H., Huang, L. L, Borland, R., & Thrasher, J. F. (2015). Was the media campaign that supported Australia's new pictorial cigarette warning labels and plain packaging policy associated with more attention to and talking about warning labels? Addict Behav.;49:64–67. [CrossRef] [PubMed]
Eriksen, M., Mackay, J., Schluger, N., Islami, F., & Drope, J. (2015). The Tobacco Atlas (5th ed.). American Cancer Society. https://ncdalliance.org/sites/ default/ files/resource_files/TA5_2015_WEB.pdf
Lakon, C. M., Wang, C., Butts, C. T., Jose, R., Timberlake, D. S., & Hipp, J. R. (2015). A dynamic model of adolescent friendship networks, parental influences, and smoking. J Youth Adolesc, 44(9), 767–1786. [CrossRef] [PubMed]
Villanti, A. C., Johnson, A. L., Glasser, A. M., Rose, S. W., & Rath, J. M. (2015). Patterns of combustible tobacco use in U.S. young adults and potential response to graphic cigarette health warning labels. Addict Behav, 42, 119–125. [CrossRef] [PubMed]
Johnson, S. E., Holder-Hayes, E., Tessman, G. K., King, B. A., Alexander, T. N., & Zhao, X. (2014). Self-reported exposure to tobacco warning labels among U.S. middle and high school students. Am J Prev Med, 47(2 Suppl 1):S69–S75. [PubMed]
Pampel, F. C., Mollborn, S., & Lawrence, E. M. (2015). Life events, genetic susceptibility, and smoking among adolescents. Soc Sci Res, 54, 221–232. [CrossRef] [PubMed]
Hwang, J., & Yun, Z. S. (2015). Mechanism of psychological distress-driven smoking addiction behavior. J Bus Res, 68(10), 2189–2197. [CrossRef]
Dawes, J. (2014). Cigarette brand loyalty and purchase patterns: An examination using US consumer panel data. J Bus Res, 67(9), 1933–1943. [CrossRef]
Lorenzo-Blanco, E. I., Unger, J. B., Ritt-Olson, A., Soto, D., & Baezconde-Garbanati, L. (2016). A process-oriented analysis of parent acculturation, parent socio-cultural stress, family processes, and Latina/o youth smoking and depressive symptoms. Int J Intercult Relat, 52, 60–71. [CrossRef] [PubMed]
Thrasher, J. F., Abad-Vivero, E. N., Huang, L., O’Connor, R. J., Hammond, D., Bansal-Travers, M., Yong, H. H., Borland, R., Markovsky, B., & Hardin, J. (2015). Interpersonal communication about pictorial health warnings on cigarette packages: Policy-related influences and relationships with smoking cessation attempts. Soc Sci Med, 164, 141–149. [CrossRef] [PubMed]
Robles, Z., Garey, L., Hogan, J., Bakhshaie, J., Schmidt, N. B., & Zvolensky, M. J. (2016). Examining an underlying mechanism between perceived stress and smoking cessation-related outcomes. Addict Behav, 58:149–154. [CrossRef] [PubMed]
Kim, A. E., Loomis, B., Rhodes, B., Eggers, M. E., & Farrelly, M.C. (2014). Influence of point-of-sale tobacco displays and graphic health warning signs on adults: Evidence from a virtual store experimental study. Am J Public Health, 104(5), 888–895. [CrossRef] [PubMed]
Mannocci, A., Saulle, R., Semyonov, L., Meggiolaro, A., & La Torre, G. (2015). From directive to practice: Are pictorial warnings and plain packaging effective to reduce tobacco addiction? Public Health, 129(12), 1563–1570. [CrossRef] [PubMed]
Laughery, K. R., & Wogalter, M. S. (2014). A three-stage model summarizes product warning and environmental sign research. Saf Sci, 61, 3–10. [CrossRef]
Richard, S. C., Craig, J., & Robertson, T. P. (2015). Graphic health warnings on cigarette packages: The role of emotions in affecting adolescent smoking consideration and secondhand smoke beliefs. J Chem Inf Model, 53(9), 1689–1699. [CrossRef] [PubMed]
Shafique, K., Khan, N. A., Abbas, M., & Hassan, S. M. (2014). Prevalence and determinants of susceptibility to cigarette smoking among school students in Pakistan: Secondary analysis of Global Youth Tobacco Survey. Subst Abuse Treat Prev Policy., 9:10. [CrossRef] [PubMed]
White, V., Webster, B., & Wakefield, M. (2008). Do graphic health warning labels have an impact on adolescents’ smoking-related beliefs and behaviours? Addiction, 103(9), 1562–1571. [CrossRef] [PubMed]
