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Substantial literature revealed that graphic tobacco warnings are effective in assisting smoking cessation. However, there is limited evidence among university students in Malaysia. This research was designed to assess the effect of graphic cigarette warning labels on warning salience, cognitive and behavioural reaction among university students. A survey was conducted among 300 UniKL MFI male students. Respondents were assessed on smoking habits, knowledge and responses towards graphic cigarette warning. This research found that graphic warnings had impacted the smokers on the label salience (61%). However, the graphics label least impacted the cognitive reaction and intention to quit. This indicated that graphic warning labels failed to influence the smokers to forgo cigarettes and avoid the warning label (91% and 75% respectively). In contrast, smokers who were aware of the health risk as well as having the intention to quit smoking increased statistically the odds of noticing and reading the label (odds ratio [OR]=17.232; 95% CI=5.496–54.028) and behavioural reaction of forgoing cigarettes and avoiding the warning label (OR=16.528, CI=3.087–38.494). The finding has clearly shown that creating awareness of the health risks of smoking yield positive results in pictorial warning label salience and behavioural reactions towards the warning label.
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