Do cigarette pictorial warnings really work for Korean smokers?

• Date: 01 November 2018
• Author: Seohyeon Lee
• DOI: http://doi.org/10.1002/pa.1709
• Published date: 01 November 2018

ACADEMIC PAPER

Do cigarette pictorial warnings really work for Korean smokers?

Seohyeon Lee

Department of Journalism and Public

Relations, Jeju National University, Jeju,

South Korea

Correspondence

Seohyeon Lee, Department of Journalism and

Public Relations, Jeju National University, Jeju,

South Korea.

Email: popoyami@jejunu.ac.kr

According to previous research, cigarette pictorial warnings are effective in not only

preventing smoking but also in inducing smoking cessation. In Korea, however, the

smoking rate has not changed much despite implementing pictorial warnings on ciga-

rette packaging. Thus, in this study, I focused on how smokers perceive cigarette pic-

torial warnings. To do this, I conducted in‐depth interviews with cigarette buyers at a

convenience store where real cigarettes were purchased, and I observed their behav-

iors at the same time. Thirty buyers responded to the interview. During the interviews,

respondents said that when they first saw a tobacco warning picture, they were

affected by it at the moment, but it did not help at all to quit smoking. Rather, they jus-

tified smoking by considering the warning picture as a picture or a cigarette company

logo. They also had a positive illusion of, “It will never happen to me”about the

smoking‐related illnesses presented in the warning pictures. Above all, cigarette warn-

ing pictures were not effective in reducing rates of smoking. This means that the

tobacco warning picture policy did not properly influence smokers' perceptions.

Further research on the usefulness of cigarette pictorial warning is needed.

1|INTRODUCTION

Vivid images make up the cigarette pictorial warnings attached to

packaging of cigarettes currently sold in South Korea: lung cancer,

laryngeal cancer, oral cancer, heart disease, stroke, secondhand smoke,

pregnant women smoking, sexual dysfunction, skin aging, and prema-

ture death (MOHW, 2016a).

Cigarette pictorial warnings designed to inform consumers about

the harms of tobacco use have been widely adopted in recent years

(Kees, Burton, Andrews, & Kozup, 2010). This is a representative

nonprice‐related smoking cessation policy recommended by the World

Health Organization (WHO), and it has been implemented in more

than 101 countries around the world since it was first introduced in

Canada in 2001 (MOHW, 2016a, b). A recent study (Noar et al.,

2011) reported that tobacco warning pictures are more effective than

warning text only and that colored warning pictures are more effective

than black‐and‐white images. Also, larger‐sized pictorial warnings are

more effective (Hammond, 2011). Many countries have implemented

tobacco warning pictures accordingly.

In Korea, after the ratification of the WHO Framework Conven-

tion on Tobacco Control in May 2005, full‐fledged discussions on

cigarette warning pictures began in July of the same year. However,

cigarette warning pictures were not easily implemented because of

the lack of government willingness to help with smoking cessation,

opposition from tobacco growers, and lobbying by tobacco companies.

The tobacco warning picture policy had been pending in the Korea's

National Assembly since 2002 and was introduced in June 2015, after

13 years of legislative efforts. All cigarette packs produced after

December 23, 2016, have been required to include both text and

pictorial warnings accordingly.

The warning picture must be presented on the front and back of

the cigarette pack. There are 10 types of warning pictures, with 5

types of diseases related to smoking and 5 types of nondiseases

related to secondary smoking, as shown in the Figure 1. Also,

according to the enforcement ordinance of the National Health

Promotion Act, warning pictures should be regularly replaced every

24 months.

According to the Korean Health Promotion Institute cigarette pic-

torial warning labels have a practical effect. A study of 18 countries

implementing graphic warnings showed the smoking rate of those over

the age of 15 has declined by an average of 4.2%. Specifically, the

smoking rate in Brazil has decreased from 35.4% in 2000 to 21.6% in

2008 (MOHW, 2016b). Korea's Ministry of Health and Welfare also

positively evaluated the effectiveness of tobacco warning pictures.

According to the results of the survey on cigarette warning images

published by the National Center for Smoking Cessation of the Korea

Received: 23 February 2018 Accepted: 26 February 2018

DOI: 10.1002/pa.1709

J Public Affairs. 2018;18:e1709.

https://doi.org/10.1002/pa.1709

© 2018 John Wiley & Sons, Ltd.wileyonlinelibrary.com/journal/pa 1of9