A comparative perception and impact of pictorial warnings on cigarette packaging among Malaysian smokers and non-smokers.

Introduction: In 2003, the World Health Organization (WHO) recommended that pictorial warnings on tobacco products be used to educate consumers on the negative health impacts associated with tobacco use. This study aimed to assess the effectiveness of pictorial warnings on cigarette packaging among smokers and non-smokers. Methods: A cross-sectional study using a self-administered questionnaire was conducted in Kuala Lumpur. Four components assessed the respondents' socio-demographics, smoking status, perceptions, and impact of pictorial warnings. Six standard cigarette pictorial warning images were included in the questionnaire. Data collected were analysed using SPSS version 29.0. Frequencies and percentages were used for categorical data, while means and standard deviations were used for continuous data. Statistically significant results were set at Results: Three hundred seventy-eight respondents participated in this study, with smokers and non-smokers divided equally, 189. Most respondents were 20-29 years old ( Conclusion: While non-smokers demonstrated greater engagement with and emotional responses to the warnings, smokers showed less frequent interaction and a tendency toward desensitisation. Although pictorial warnings play a vital role in raising awareness of the health risks of smoking, particularly lung and mouth cancer, their effectiveness in encouraging smoking cessation among smokers remains limited.