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Assessment of Tobacco Pictorial Health Warnings and Preference of Text Warnings
J Korean Soc Res Nicotine Tob 2018; 9(1): 26-33
Published online June 15, 2018
© 2018 The Korean Society for Research on Nicotine and Tobacco.

Jieun Hwang1, Yuseon Yang2, Seoun-young Lee2, Joung Eun Lee2, Yumi Oh2*

1Graduate School of Public Health, Seoul National University, 2Korea Health Promotion Institute, Seoul, Korea
Correspondence to: 삤쑀誘
븳援嫄닿컯利앹쭊媛쒕컻썝 꽌슱떆 以묎뎄 異⑸Т濡3媛 (슦)04554
Tel: 02-3781-2258 Fax: 02-3781-3568 E-mail:
Received May 13, 2017; Revised September 20, 2017; Accepted March 21, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Pictorial health warning (PHW) is a cost-effective tobacco control policy to convey health risks information caused by smoking. It should be developed to motivate smokers to quit as well as to prevent smoking initiation of non-smokers. To provide preliminary data for developing effective tobacco health warnings, surveys were conducted to study attitude change toward smoking after being exposed to PHWs and to assess preference of text warnings by forms of description. Methods: 61 male and female adults aged 19 and more were recruited based on their smoking history. Changes in knowledge on smoking, perception of smoking and smoking cravings after exposure to the PHWs were scored on a five-point scale such that the lower the score, the more negative the attitudes toward smoking. Participants were also asked to choose one text warning that conveys best the message of PHW among five types of text warnings. Results: Participants scored that smoking has negative or very negative impacts on health, both before and after being exposed to PHWs. After exposure to the PHWs, more participants answered that smoking has very negative impacts on health. Perception of smoking also identified as negative before and after exposure to the PHWs, and the score was lowered after being exposed (pre-exposure: 2.11, post-exposure: 1.97). Smoking cravings score was lowered after exposure, from 2.18 to 1.90. Meanwhile, informational text warnings were most preferred, followed by emotional and negative text warnings. In terms of frequency, informational warnings were selected 11 times, and testimonial warnings and emotional warnings were selected 3 times each. Conclusion: This study found that PHWs affect knowledge on smoking, perception of smoking and smoking cravings. It provided sound evidence on implementation of tobacco pictorial warnings in order to raise awareness on the consequences of smoking, promoting public support for tobacco control.
Keywords : Pictorial Health Warnings; Text Warnings; Smoking; Cessation
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