Researchers say most people are still not aware of the full danger of smoking.

A study from Cancer Council Victoria has found that awareness of the causality between smoking and a range of harms varies widely.

Participants in a survey were asked; “If you smoke, how likely is it that you will increase your risk of …”, with one of 23 health conditions inserted into the question.

Responses of “very likely” and “likely” were combined and compared with the combined responses of “neither likely nor unlikely”, “unlikely”, “very unlikely”, “not sure”, and “prefer not to say”.

“The proportion of respondents aware that smoking increases risk ranged between 27.1 per cent for rheumatoid arthritis and 91.2 per cent for lung cancer,” reported lead researcher Professor Melanie Wakefield.

“Only nine of the 23 conditions were endorsed by more than two-thirds of the sample; six cancers were endorsed by fewer than two-thirds. Endorsement of harms featured in graphic health warnings (GHWs) in Australia during the preceding 5 years under the Competition and Consumer (Tobacco) Information Standard 2011 was significantly higher than for those that were not, both overall (73.5 per cent v 48.9 per cent) and among smokers (67.5 per cent v 39.5 per cent).

“Awareness was generally highest among never smokers, but the relative ordering of the 23 conditions from highest to lowest awareness was similar for all groups, indicating that the conditions with greatest potential for knowledge gains are the same for never, former, and current smokers.”

The images currently used on Australian cigarette packets have been in circulation since 2012.

“GHWs on tobacco products are a critical component of comprehensive tobacco control programs, and highly cost-effective for increasing knowledge about the harms of tobacco,” wrote Wakefield and colleagues.

“GHWs require updating regularly to maintain salience and impact.”

The study is accessible here.