Evaluating the impact of Graphic health warning intensity and individual predispositions on Anti- smoking intentions among non smoking Adolescents attending high school in Addis Ababa, Ethiopia: A MultiCenteric Quasiexperimental Study

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2024-02

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Addis Ababa University

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Background:Cigarette smoking poses a significant public health threat, and its detrimental effects are particularly concerning among adolescents. Graphic Health Warnings (GHWLs) on cigarette packs have emerged as a low-cost yet effective tool to deter tobacco use and reduce mortality. While Ethiopia adopted the Framework Convention on Tobacco Control (FCTC) recommendations and implemented GHWLs, their effectiveness in influencing adolescents' emotional responses, risk perception, and smoking intentions remains locally unevaluated. Objective:To asses effectiveness of GHWLs in influencing perceptions of smoking and anti-smoking intentions in adolescent non-smokers attending high school in Addis Ababa Ethiopia Methods:This is a Quasi experimental study which utilized structured interviews to investigate the impact of GHWLs on late adolescents' perceived message and Impact related effectiveness. A sample of 525 non-smoking high school students in Addis Ababa were exposed to either mild or strong GHWLs and assessed based on their emotional responses, perceived risk, and intentions to smoke. The extracted data was entered to SPSS version 26, frequencies, proportions, and summary statistics is used to describe the study population in relation to relevant variables. Variables with p value of <0.2 on the bivariate analysis will be included in the multivariate one. Analysis is carried out to see the effect of independent variable on the dependent variable and P- value <0.05 is considered significant. Result:A total of 525 Adolescents attending in Four high schools in Addis Ababa were included in the study. There were 54.5% female participants. The age of participants ranges from 13- 20yrs, majority(52.6%) were in the 16-17 age range. Students attending governmental schools were 51.4% and 48.6% were attending in private schools. The Multivariate regression analysis showed that exposure to strong warnings increased odds ofthe impact related dimension(intention to avoid smoking and emotional response) and by 20.5x (Adjusted Odds Ratio (AOR) = 20.5, 95% Confidence Interval (CI) = (9.47-44.7). Conclusion:This study investigated the effectiveness of anti-smoking graphic warnings on students in Addis Ababa high schools. The findings suggest that strong warning images are more impactful than weak warning images. Students exposed to strong warnings showed higher agreement with the effectiveness of the Strong GHWL to Convey anti smoking messages, to elicit stronger negative emotions and impact on their anti-smoking intentions. These results support the use of graphic health warnings as a tool to deter smoking initiation among youth

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