Background: Warning labels on tobacco products provide an effective way of communicating the consequencesof tobacco use. Research has shown that larger and colorful warnings placed on packaging are more effectivefor informing consumers and general public. However, primarily due to powerful lobbying by the industry,pictorial health warnings in India experienced constant delay in introduction and dilution of content. Thecurrent warnings appearing on tobacco products consist of drawing of a scorpion on smokeless forms of tobaccoand pictures and X- rays of diseased lungs for smoking forms. Methodology: To understand people’s attitudetowards the pictorial warning and their understanding of the pictures, a study was planned in two phases. Thefirst phase was qualitative with focus group discussion and second, a population based survey for validatingthe findings. Results: The findings of the study suggested that the mandated pictorial warnings do not serve thedesired purpose since they are not properly understood. The scorpion becomes associated with the product in anon-scientific manner. X-rays of lung are hardly understood by anybody and pictures of diseased lungs are notused by tobacco manufacturers. Conclusion: The results of both the focus group discussions and the field surveyindicate that most people have seen text and pictorial warnings on smokeless and smoking tobacco products, butthat they lack relevance to the text messages. Irrespective of education the early proposed pictorial warningsby the government were more effective than the currently implemented warnings. People would like to see thewarnings mainly in Hindi and Marathi (local language) and want them to be placed on the top or middle of bothsides of tobacco packaging.
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