Demographic characteristics associated with awareness of cigarette health warnings and thinking about quitting among current adult cigarette smokers in Zambia, 2017

Masauso M Phiri; April D Summers; Alissa C Kress; Isabel Garcia de Quevedo; Ralph Caraballo; Evelyn Twentyman

doi:10.18332/tpc/144772

Demographic characteristics associated with awareness of cigarette health warnings and thinking about quitting among current adult cigarette smokers in Zambia, 2017

Tob Prev Cessat. 2022 Feb 11:8:05. doi: 10.18332/tpc/144772. eCollection 2022.

Authors

Masauso M Phiri¹, April D Summers², Alissa C Kress², Isabel Garcia de Quevedo², Ralph Caraballo², Evelyn Twentyman²

Affiliations

¹ Tobacco Control Scholars Program Fellow Centre for Primary Care Research, School of Medicine, University of Zambia, Ridgeway, Zambia.
² Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States.

Abstract

Introduction: Noticing health warnings on cigarette packages has been associated with thinking about quitting. This study examined sociodemographic characteristics associated with awareness of health warnings on cigarette packages and thinking about quitting because of health warning labels among adults who currently smoked tobacco.

Methods: We analyzed data from the 2017 Zambia WHO STEPS survey (STEPwise approach to surveillance) for noncommunicable disease risk factors. Descriptive analyses and logistic regression were performed to assess the association of select sociodemographic characteristics with awareness of health warnings and thinking about quitting because of health warnings.

Results: Adults who currently smoked tobacco who were aged 30-44 years, of Chewa ethnicity, or with a formal education, were more likely to be aware of health warnings than those aged 18-29 years (adjusted prevalence ratio, APR=1.26; 95% CI: 1.02-1.54), of Bemba ethnicity (APR=1.43; 95% CI: 1.17-1.74), or with no formal education (APR: 2.61-5.95). Among all adults who currently smoked, those of Chewa ethnicity (APR=1.55; 95% CI: 1.03-2.35), or with a formal education (APR:1.80-4.38), were more likely to report thinking about quitting because of health warnings than those who were of Bemba ethnicity or with less than primary school education level. Women who currently smoked were 49% less likely (APR=0.51; 95% CI: 0.23-0.84) to report thinking about quitting than men. Among a subset of adults who currently smoked who were aware of health warning labels, no sociodemographic characteristics were significantly associated with thinking about quitting in unadjusted or adjusted models.

Conclusions: Sociodemographic characteristics such as sex, ethnicity, and education level were significantly associated with awareness of cigarette health warnings. Among cigarette smokers aware of health warnings, no sociodemographic differences in thinking about quitting were found. Tobacco control campaigns may need to target people of ethnicities with the highest smoking prevalence in the country.

Keywords: awareness; cigarette; health warnings; smoking; sociodemographic characteristics; thinking about quitting.