Exposure to Tobacco Health Warnings and Quitting Intentions Among Indian Smokers: Evidence from GATS-2

The study aims to assess the association between exposure to health warnings on tobacco products and self-reported quitting intentions among Indian adult smokers using nationally representative data.

We conducted a cross-sectional analysis of 9,398 current smokers from the Global Adult Tobacco Survey-2 (2016-2017). Descriptive statistics were used to summarize socio-demographic characteristics and exposure to tobacco health warnings. Bivariate associations were assessed using chi-square tests, and multivariable logistic regression was used to estimate adjusted odds ratios (AORs) for predictors of quitting intention.

Half of smokers (49.7%) expressed an intention to quit, while 70.1% reported noticing health warnings on tobacco packaging. Quit intentions were significantly higher among those who noticed warnings (53.1%) compared to those who did not (41.6%). In multivariable analysis, noticing health warnings was associated with increased odds of intending to quit (AOR = 1.191; 95% CI: 1.072-1.325; p < 0.001). Prior quit attempts (AOR = 6.529; 95% CI: 5.870-7.263), knowledge of smoking harms (AOR = 1.410), and high nicotine dependence (smoking within 30 min of waking; AOR = 1.156) were also significant predictors. Higher education was positively associated with quit intention, while female smokers and Scheduled Tribe respondents had significantly lower odds.

Graphic health warnings on tobacco packaging are significantly associated with increased quitting intentions among Indian smokers. These findings support the continued use and enhancement of pictorial health warnings as a low-cost, population-level intervention. Strengthening health communication, especially for marginalized groups and low-literacy populations, remains a public health priority.