BACKGROUND: There is growing interest in a novel policy which would require a warning on each cigarette stick. To our knowledge, there is no study in Argentina or Latin America to have explored adolescent’s perceptions of health messaging on cigarettes.
METHODS: Eight focus groups were conducted in four Argentine cities (Córdoba, Quilmes, San Salvador de Jujuy, Santa Rosa), with adolescents (n=51) stratified by sex, age (13-14, 15-17) and smoking susceptibility (susceptible, non-susceptible). Participants were shown cigarettes featuring five different warning messages, with one of these messages also including a toxic (skull and crossbones) symbol and another one presented in either black or red typography. Discussions were digitally recorded, transcribed, and analyzed using NVivo v20.
RESULTS: Most groups felt that cigarette sticks with warnings may help deter experimentation among non-smokers, but they would likely be ineffective for current smokers. They highlighted their potential utility for young people or new smokers, who often do not buy packs but instead buy or borrow single cigarettes, thus not necessarily being exposed to on-pack warnings. Some non-susceptible groups stated they would not try a cigarette, regardless of the presence or absence of a warning. Several participants mentioned that dissuasive cigarettes could help denormalize tobacco. In most groups the cigarette featuring a message and toxic symbol was viewed as the most dissuasive. “Smoking a little also kills” was also seen as likely to have a deterrent effect, as it challenges the belief that only heavy smokers are at risk, but messages about environmental damage and cosmetic effects were generally regarded as less effective. “Smoking controls you” received mixed reactions. Most groups considered red typography more deterrent. Adolescents suggested incorporating messages using strong and direct language about the harm smoking causes to others, and difficulty in quitting.
CONCLUSIONS: Warnings on cigarettes may be beneficial for deterring some younger, susceptible non-smokers.