Pictorial health warnings on cigarette packs and effect on smoking: Medical student’s perspective

Nazish Masud, Zakariya Khalid Azzahrani, Jawaher Ali Towhari, Meshari Fawaz Alquayt, Fouad Adel Kanadily, Abdulaziz Muddhi Aldosari, Raed Sami Altowairiki, Emad Masuadi

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the knowledge, attitude and practice of medical students towards pictorial warnings on cigarette packets. Method: The cross-sectional study was conducted from October 2017 to December 2018 at King Saud bin Abdulaziz University for Health Sciences Riyadh, Saudi Arabia, Riyadh, Saudi Arabia, and comprised medical students from third to sixth year. Data was collected using a self-administered structured questionnaire which was validated through pilot-testing. A five-point Likert scale was used to access each item, with 1 as strongly disagree and 5 as strongly agree. Data was analysed using SPSS 22. Result: Of the 335 subjects, 181(54%) were males. The overall mean age was 23±2.2 years and 307(92%) were nonsmokers. The overall knowledge, attitude and practice was low with a total median score of 3.3 (interquartile range: 3.1-3.6). However, knowledge was better 4 (interquartile range: 3.7-4.7). Males had significantly more knowledge about the pictorial health warnings compared to females (p<0.001). Having a smoker friend had significantly better effect on the overall knowledge and attitude with (p<0.05). Conclusion: The study concludes that pictorial warnings are not helpful in persuading the current smokers to give up smoking. The knowledge about who take the decision of printing these warnings is not known to majority of the participants. Those who had a friend smoker had considerably better knowledge about pictorial warnings. Display of pictorial warnings might not be enough to serve the purpose of discouraging future smokers. Innovative strategies involving the non-smokers (peers and friends) should also be considered in the new era for cessation of smoking.

Original languageEnglish
Pages (from-to)1042-1047
Number of pages6
JournalJournal of the Pakistan Medical Association
Issue number6
Publication statusPublished - Jun 2020
Externally publishedYes


  • Cross sectional
  • Health warnings
  • KAP
  • Peer influence

ASJC Scopus subject areas

  • General Medicine


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