Aya Mostafa|Heba Tallah Mohammed|Rasha Hussein|Wafaa Hussein|Mahmoud Elhabiby|Wael Safwat|Sahar Labib|Aisha Aboul Fotouh
Do pictorial health warnings on waterpipe tobacco packs matter? Recall effectiveness among Egyptian waterpipe smokers & non-smokers
Ain Shams University|University of Waterloo|Ain Shams University|Ain Shams University|Ain Shams University|Ain Shams University|Ain Shams University
introduction despite global rise waterpipe tobacco smoking wts effectiveness waterpipe tobacco health warnings remain understudied especially countries high wts rates egypt employing waterpipe tobacco labelling decade however effectiveness unknown overall aim measure effectiveness pictorial health warnings phws waterpipe tobacco packs wtps participant memory recall investigate whether induced behavioural responses waterpipe smokers deterred uptake wts nonsmokers examining differentials effectiveness among sociodemographic subgroups subjects methods conducted two surveys including 1490 adult current waterpipe smokers 73 former waterpipe smokers 451 nonsmokers cairo rural village egypt 20152017 participants noticed phws wtps asked questions salience communication health risks public support cognitive processing selfreported behavioural responses current waterpipe smokers reduce consumption forgo smoke quit attempts former waterpipe smokers quit nonsmokers deter wts initiation univariate multivariable statistical analyses performed results participants mean age 35 years mostly males 904 waterpipe smokers 740 rural residents 593 approximately twothirds participants noticed phws wtps salience significantly less among females urban residents participants high literacy threequarters participants reported wts health risks communicated warnings least half participants cognitively processed warnings 563 thought warnings wtps sight nonsmokers understood warnings 832 discussed others 903 significantly current 760 725 respectively former waterpipe smokers 810 619 respectively participants reported phws wtps motivated 585 waterpipe smokers think quitting 645 reduce consumption 422 forgo smoke 245 attempt quit 571 former waterpipe smokers successfully quit 593 nonsmokers remain smokefree conclusions findings suggest inserting phws wtps effective waterpipe tobacco labelling policy countries similarly high rates wts consider adopting wtp phws within comprehensive regulatory framework