Page 39 - FINAL COMPENDIUM 2020-2021 27.2.2022

PERCEIVED EFFECTIVENESS OF THE PICTORIAL HEALTH WARNINGS ON CIGARETTE
PACKS IN MALAYSIA
NMRR-18-3430-45394

‘Ainun Mardhiah MAH, Marhazlinda J, Roslan S

Introduction: Pictorial health warnings (PHWs) on cigarette packs is one of the tobacco-
free initiatives, targeting both smokers and non-smokers. Since its implementation in
2009, little is known about the effects of the PHWs. Objectives: To assess how the public
perceived the effectiveness of existing PHWs in Malaysia. Materials and methods:
Twenty-four participants aged 18 - 40 years old in Malacca were divided into four focus
group discussions; non-smokers, professionals, male smokers aged 18 -25 and aged 26 -
40. Using the prepared leading questions and a set of 12 actual cigarette packs available
in the market during the study period, the facilitator moderated the group discussions.
The audio recorded data were analysed using thematic analysis and the Atlas.ti version
8.0 software. Results: Participants perceived the PHWs showing the lung, neck, and oral
cancers as effective, while the PHW of gangrene and pregnancy-related effects as partially
or totally ineffective, resulting from unfamiliarity with those effects, inadequate
knowledge of second-hand smoking (SHS) effects on pregnant mothers and babies, the
images overshadowed by more attractive packaging colours and designs, the perception
that the effects in the picture were caused by other factors not related to smoking, the
unclear, not scary, not painful looking, and not severe images, and the belief that
gangrene foot was solely due to diabetes. In general, participants perceived the existing
PHWs in Malaysia as only effective to non-smokers and non-chronic smokers. Discussion:
After a decade of implementation, the public perceived PHWs as not entirely effective.
Hence, improving public knowledge on the smoking effects, addressing the identified
weaknesses on the images, form, contents, and desensitisation of PHWs would better the
efficacy of future PHWs. Conclusion: Depending on the PHWs, the public perceived the
existing PHWs in Malaysia as not effective, partially effective, or effective.

Keywords: PHW, Smoking effects, Effectiveness, Public.

1 place winner of the virtual poster presentation at the 22 NIH Scientific Conference 2021 on 21– 23 September 2021
st
nd
entitled “ Perceived Effectiveness of the Pictorial Health Warnings on Cigarette Packs in Malaysia”
Dr ‘Ainun Mardhiah Meor Amir Hamzah
Pasir Akar Dental Clinic
Besut
Terengganu

Dr Marhazlinda Jamaluddin
Prof. Dr Roslan Saub
Department of Community Oral Health and Clinical Prevention
Faculty of Dentistry
University of Malaya
Federal Territory of Kuala Lumpur

15