title: Awareness of smoking risks and attitudes towards graphic health warning labels on cigarette packs: a cross-cultural study of two populations in Singapore and Scotland.
abstract: BACKGROUND
  Little is known about the level of awareness of blindness as a smoking-related condition, although the relationship has been well established.
  
  
  OBJECTIVE
  To compare the awareness of smoking risks and the impact of graphic health warning labels on cigarette packs in discouraging smoking among adults in Singapore and Scotland.
  
  
  METHODS
  A cross-sectional survey using a structured interview of adults in ophthalmic, general medical, and general surgical outpatient clinics in Singapore and Scotland.
  
  
  RESULTS
  One hundred and fifteen out of 163 (70.6%) outpatients in Singapore and 105 out of 112 (93.8%) outpatients in Scotland responded to the study. In both samples, awareness levels for smoking-related diseases such as lung cancer, mouth and throat cancer, heart disease, and stroke were all greater than 85%. These were found to be significantly higher than the level of awareness of blindness as a smoking-related condition (chi (2)-test, P<0.001). Although the awareness of blindness as a smoking-related condition was greater in Singapore (36.5%) than in Scotland (30.5%), this difference was not statistically significant. More than half of the respondents indicated that graphic health warning labels would be effective in discouraging them from smoking.
  
  
  CONCLUSIONS
  Graphic health warning labels reading 'Smoking causes blindness' printed on cigarette packs may be useful in raising public awareness of blindness as a smoking-related condition and discouraging the habit of smoking in Singapore and Scotland.
authors.affiliation: Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland, UK. eyesofchinablue@gmail.com
authors.forename: D H L
authors.initials: DH
authors.lastname: Ng
authors.forename: S T D
authors.initials: ST
authors.lastname: Roxburgh
authors.forename: S
authors.initials: S
authors.lastname: Sanjay
authors.forename: K G
authors.initials: KG
authors.lastname: Au Eong
mesh_terms: D000328:Adult; D000329:Advertising; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D001766:Blindness / Q000209:etiology* / Q000517:prevention & control; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011356:Product Labeling; D012606:Scotland; D012846:Singapore; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology; D000074606:Smoking Prevention; D055815:Young Adult