The impact of pictorial health warning on smoking behavior in Thailand

Abstract

In Thailand, tobacco smoking is the second most significant risk factor for non-communicable diseases, with a large economic burden due to smoking-attributable illness. Pictorial health warning has been implemented since 2004 to inform smokers of negative consequences of smoking, and reduce the number of smokers. The purpose of this study is to evaluate the impact of pictorial health warning on cigarette package on smoking behaviors in Thailand.

This study analyzes secondary data from a national survey on Cigarette Smoking and Alcohol Drinking in 2014 by the National Statistical Office of Thailand. The survey covers 25,758 households, with participants aged more than 15 years. Logistic regressions and linear regressions are used to evaluate the impact of exposure to pictorial health warning on the probability of smoking, smoking behaviors (in terms of smoking frequency and number of cigarette smoked per day), and the intention to quit smoking.

The results show that, in 2014, the majority of respondents noticed pictorial health warning on cigarette packages: 94.92% of smokers and 87.5% of non-smokers. Exposure to pictorial health warning has a negative impact on the probability of becoming smokers significantly, i.e. 24.2% less likely to smoke. Although exposure to pictorial health warning has a statistically insignificant impact on the smoking frequency and the number of cigarettes consumed per day, it plays an important role on the intention to quit and the number of quit attempts. Smokers exposed to pictorial health warning have a higher probability of quitting and a higher probability of having attempted to quit more than 3 times by 10.8% and 5.6%, respectively. The study concludes that pictorial health warnings on the cigarette packages are an effective tool to prevent non-smokers from initiating smoking and they raise concerns such that current smokers are more likely to attempt quitting.