Health warnings on cigarettes fail to boost quitting rates, study finds

Despite the prominent graphic health warnings on cigarette and heated tobacco product packaging in South Korea, a recent study indicates a concerning trend: the rate of smokers quitting has actually declined.

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The proportion of smokers who believe warnings increase their chances of quitting has fallen.

The 'Korean Adult Perception and Response to Warnings on Cigarettes and Heated Tobacco Products' study by the Korea Health Promotion Institute analyzed data from over 11,000 cigarette smokers and 5,700 heated tobacco users. While the percentage of smokers who frequently noticed the warnings rose from 37% in 2020 to 50% in 2023, and those who read them increased from 19% to 23%, their belief that these warnings boost quitting chances dropped to just 11%. Furthermore, cognitive responses, such as thinking about health risks due to warnings, decreased from 33% to 26%, and the proportion of smokers delaying smoking because of warnings fell from 32% to 30%.

A similar pattern emerged among heated tobacco users. Their awareness of warnings doubled to 50% and reading them increased to 25%, but cognitive responses dropped from 21% to 13%, and delaying smoking fell from 39% to 32%. Notably, the agreement that warnings increase the likelihood of quitting fell from 20% to 12%.

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Specifically, the content of the warnings needs attention. Korea's cigarette warnings present 10 health risks, while heated tobacco warnings only include nicotine addiction and carcinogen exposure.

Researchers attribute the limited impact to several factors, including the short revision cycle of warnings, low perception of risks associated with heated tobacco products, and marketing by tobacco companies promoting reduced harm. They recommend strengthening warnings with messages emphasizing the benefits of quitting and introducing plain, standardized packaging, citing international examples where such measures reduced e-cigarette use intention among young people. The study concludes that while attention to warnings has increased, their effectiveness in prompting quitting behavior remains low, necessitating innovative policy interventions.

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Introducing innovative additional policies, such as attachment documents emphasizing efficacy messages that highlight the benefits of quitting and the belief in successful quitting, and plain standardized tobacco packaging without brand imagery, may be necessary.