Evaluation of the relationship between perception of tobacco packaging pictorial warnings and the nicotine addiction levels of smokers who admitted to smoking cessation clinic in Malatya, Turkey

Objective: In this study, we aimed to investigate relationship between perception of tobacco packaging pictorialwarnings and the nicotine addiction levels of smokers who admitted to smoking cessation clinic in Malatya,Turkey.Methods: Three hundred fifty-six patients were enrolled from the Malatya State Hospital Smoking CessationClinic. The characteristics of the patients, and number of cigarettes smoked were evaluated. The Fagerströmtest for nicotine dependence was used. Fourteen of the best-known and most effective pictorial health warningson cigarette packages were shown and evaluated.Results: The two best-known pictorial warnings in both male and female participants were pictorial 6, “Smokecontains benzene, nitrosamines, formaldehyde, and hydrogen cyanide” and pictorial 7, “Smoking causes fatallung cancer”. The third best-known pictorial warning for female was pictorial 4, “Smokers die younger,” andfor male it was pictorial 1, “Smoking may reduce blood flow and causes impotence”. Female were most affectedby pictorial 11, “Protect children; don’t make them breathe your smoke’’, and male were most affectedbypictorial 1, “Smoking may reduce blood flow and causes impotence” (p < 0.043 and p = 0.01, respectively).Fagerström scores compared with pictures mostly known and affected by participants, the highest and lowestscores belongs to same pictures; the highest Fagerström score was 8.29 ± 2.14 for best known and 8.25 ± 2.19for most affected picture is number 2; the lowest Fagerström score was 6.46 ± 2.55 for best known and 6.56 ±2.68 for most affected picture is number 3.Conclusion: The effect of pictures about the decision to quit smoking may be investigated by a qualitativestudy especially for pictures 1, 2, 4, 6, 7, and 11.

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