Determinants of awareness on pictorial health warnings on tobacco products in an Eastern state of India

Abstract

Background: Pictorial health warnings (PHW) are an effective strategy to deter or reduce tobacco use. This study was conducted to determine the level of awareness of PHWs on tobacco products and their correlates among adults attending the outpatient department (OPD) of a tertiary care facility in Eastern India. Materials and Methods: This cross-sectional study was conducted over a period of 3 months among 307 patients aged 18 years to 65 years. A pre-tested semi-structured questionnaire was used for the collection of data and inferential statistics were performed using JAMOVI version 2.3.21. Results: About 84% (95% CI, 78.9-87.2) of the participants were aware of PHW on tobacco products, 82.4% (95% CI, 77.8-86.3) for smoked forms and 51.8% (95% CI, 46.2-57.3) for smokeless forms. More than half of the participants felt that the current PHW were ineffective. Male [AOR, 3.13; 95% CI, 1.33-7.37], being educated [AOR, 3.37; 95% CI, 1.29-8.76], employment [AOR, 5.65; 95% CI, 1.21-26.30] and ever-tobacco use [AOR, 3.23; 95% CI, 1.43-7.2] were found to be independent correlates of PHW awareness for smoked tobacco products, whereas as being male [AOR, 2.01; 95% CI, 1.02-3.95] and being young (18-30 years) [AOR, 2.51; 95% CI, 1.08-5.84] were found to be the independent predictors of PHW awareness for smokeless tobacco products (SLT). Conclusion: Four out of every five individuals were aware of pictorial health warnings (PHW) on tobacco products; however, it was much less for SLT compared to smoked tobacco products. Male, being educated, employment and ever-tobacco use were independent correlates of awareness for the smoked form of tobacco products, whereas being young (18-30 years) was an independent predictor of awareness for SLT.