[Analysis of the impact of cigarette pack graphic warnings on Mexican smokers].
OBJECTIVE
To determine which graphic warnings on cigarette packs (images on the labels indicating the negative impact on health that tobacco can have) provoke the strongest desire to quit smoking among adult Mexican smokers.


METHODS
A pile sort method was used among 60 smokers over 18 years old to determine which images made them think about quitting smoking. Averages were determined and non-parametric statistical methods were used to determine differences in ranks.


RESULTS
Within each of the five themes, one or two graphic warnings provoked the strongest responses in smokers. The graphic warnings with the greatest impact used the following images: a close-up of a lung tumor; a man with cancer of the larynx with a large tumorous mass on the exterior part of his neck; an unconscious young man in a bed in an intensive care unit with text mentioning benzene, formaldehyde and cyanide as tobacco components; an image of two healthy children indicating that cigarettes contain carbon monoxide; an image of a dead fetus in a specimen jar; and a close up of a mouth with yellow, rotting teeth and text describing tooth loss and mouth cancer as a result of tobacco use.


CONCLUSIONS
The graphic warnings used on cigarette packs in other countries could contribute to cessation among Mexican smokers and should be implemented in Mexico.
Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México. jfthrasher@insp.mx
James Francis
JF
Thrasher
Betania
B
Allen
Luz Myriam
LM
Reynales-Shigematsu
Rafael
R
Anaya
Eduardo
E
Lazcano-Ponce
Mauricio
M
Hernández-Avila
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011356:Product Labeling; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D018709:Statistics, Nonparametric