RT Journal Article SR Electronic T1 ‘If I hadn’t seen this picture, I'd be smoking’—perceptions about innovations in health warnings for cigarette packages in Brazil: a focus group study JF Tobacco Control JO Tob Control FD BMJ Publishing Group Ltd SP tobaccocontrol-2020-056360 DO 10.1136/tobaccocontrol-2020-056360 A1 Cristina de Abreu Perez A1 Luiz Antonio Bastos Camacho A1 Felipe Lacerda Mendes A1 Andre Luiz Oliveira da Silva A1 Valeska Carvalho Figueiredo A1 Gloria Maria de Oliveira Latuf A1 Ana Marcia Messeder Sebrao Fernandes A1 Patrícia Gonçalves Duarte Albertassi A1 Patricia Aleksitch Castello Branco A1 Patricia Francisco Branco A1 Stefania Schimaneski Piras A1 Maribel Carvalho Suarez YR 2021 UL http://tobaccocontrol.bmj.com/content/early/2021/07/20/tobaccocontrol-2020-056360.abstract AB Objective To investigate the perceptions of young people and adults, smokers and non-smokers about the current set of innovations introduced in 2018 into the Brazilian tobacco products’ health warnings.Methods Twenty focus groups were conducted in five state capitals in Brazil. The participants (n=163) were segmented by smoking status, age (15–17 years, 18–55 years) and social grade (C, D–E classes) to examine cigarette packaging and explore the participants’ perceptions of health warnings.Results Health warnings capture attention, eliciting apprehension, fear, disgust and concern about the negative consequences of cigarette consumption. The 2018 Brazil health warnings are spontaneously recalled by participants, even without the presence of cigarette packages. However, the analysis also reveals the challenges of overcoming communication barriers and distorted interpretations, especially among smokers. The inclusion of direct and provocative stimuli, such as the use of the word ‘you’, attracts attention and creates more proximity to the recipient of the message. The results also highlight the interest and fear elicited by warnings on toxic constituents and the importance of using contrasting colours in warnings, which differentiate them from the colours of cigarette packs.Conclusion Introducing innovative components in health warnings can catch consumers’ attention but considering that the interviewees encountered difficulties interpreting textual warnings about toxic constituents in cigarettes, the study reinforces the importance of adopting direct language and pictures, instead of text, which can visually transmit the warning messages and the use of specific wording that generates proximity between the emitter and receiver.All data relevant to the study are included in the article or uploaded as supplementary information.