Perceived effectiveness of larger graphic health warnings and plain packaging among urban and rural adolescents and adults of Delhi and Telangana, India

摘要

Background Plain packaging has been demonstrated to be effectivein Australia, where it led to increased quit attempts among adult smokers.Graphic Health Warnings (GHWs) on tobacco packs in India have increased from40% to 85%. This qualitative study assesses perceptions of Indian adults andchildren about impact of larger GHWs and plain packaging of tobacco products.Methods Focus Group Discussions (FGDs),conducted with childrenaged 13-17 years and adults aged 17+ years in the community settings. SeparateFGDs were conducted with adults (male and female) and children (boys and girls)in selected urban and ruralcommunities in Delhi and Telangana in2016. Four dummytobacco packs categories [A-40% old GHWs, B-40% new GHWs, C-85% new GHWs; D-85%new GHWs with plain pack] were shown. Datawas coded and thematic analysis undertaken with using Atlas.ti 6.2.Results In total, fourteen (six in Delhi and eight inTelangana) FGDs were conducted. Participants highlighted the importance oflarger GHWs on tobacco products in demonstrating the consequences of tobacco useand limit the pack's appeal. Participants opined, category C and D warningswere most effective to curb tobacco use. Category D was considered the mostunattractive pack due to larger GHW, dull color and brand name not being prominent.Conclusions Larger GHWs and PP were perceived to beeffective in reducing tobacco use. Plain packaging was further perceived to reducethe attractiveness of pack, enhance noticeability of the GHW, deter new users,and improve quitting among users.