In October 2015, the government of Nepal enforced a mandatory 90% PHW on the pack of tobacco products. However, tobacco companies in Nepal have utterly undermined the law. Only a few companies have complied with the 90% PHW law. However, major tobacco companies, such as Surya Nepal Pvt. Ltd. in Nepal are supplying, selling, and distributing tobacco products without compliance with the compulsory 90% PHW. Tobacco products against laws are widely available in the market and no action has been taken between the law enforcement agencies and the government. This leaves no doubt in stating that the tobacco industry has a huge influence on laws enforcement authorities and government officials.
Research Study: Evidence of the Effectiveness of Pictorial Health Warnings on Cigarette Packaging in Nepal
Abstract:
Background: Tobacco Control Act of 2010 mandates the government to implement at least 75% pictorial health warnings (PHWs) on tobacco packaging which was enforced in 2013. The purpose of the study was to assess the effectiveness of PHWs and their impact on policy change.
Methods: A cross-sectional study was conducted in 9 cities between September 2014 and March 2015. Direct interviews were made among 2250 randomly selected individuals. The effectiveness of PHWs was measured as perceived: i) scariness; ii) quit motivation iii) convincing youth not to start smoking; iv) encouraging ex-smokers to remain as quitters; v) building public awareness. Logistic regression analysis was used to determine the factors associated with the effectiveness of PHWs.
Results: Of the 2250 participants, 29.8% (670) were current smokers, 8.6% (193) were ex-smokers and 97.6% believed that smoking was addictive. PHWs made 83% of the participants scared. Participants believed that PHWs would be effective in motivating smokers to quit (80.2%), convincing youth not to start smoking (86.8%), encouraging ex-smokers to remain quitters (89.1%), and building public awareness of the dangers of smoking (94%). PHWs made 58% of the current smokers intend to quit smoking and reduced their daily intake of cigarettes from 11 to 5 on average. Current smokers preferred to purchase loose cigarettes rather than a pack. The covariates significantly associated with the effectiveness of PHWs were current smokers, ex-smokers, and addiction.
Conclusion: PHWs were found important to motivate smokers to quit smoking, reduce consumption of cigarettes, and prevent relapse in ex-smokers. Evidence from the study had triggered policy changes which included enlargement of the size of PHW to 90% and the release of notification to ban the selling of loose cigarettes. Thus, the warning messages with pictures are required to be improved and rotated.
