Harm Perception in Response to Pictorial Warning Labels Predict Higher Non-Smoking Intention among Korean Adolescents

Because of recent controversy surrounding the use of excessively graphic pictorial warning labels (PWL) on cigarette packs in South Korea, it is necessary to provide evidence to evaluate their effectiveness as a tobacco control policy according to the harm perception they evoke. An analysis was performed using a nationally representative survey conducted six months after the introduction of PWLs in South Korea. Among 62,276 survey participants, 43,231 students from grades 7-12 who had seen a PWL in the past 30 days comprised the research sample. Non-smoking intention was evaluated according to the harm perception evoked by PWLs, which predicted higher non-smoking intention among adolescents. Non-smoking intention was particularly higher in daily smokers with harm perception (52.0%) than those who have never smoked and have no harm perception (40.1%). In the case of those who perceived harmfulness, non-smoking intention was formed in about 45% of daily smokers who had no experience of trying to quit in the last 12 months. Therefore, it is important to select PWLs that can arouse in adolescents sufficient harm perception of smoking.