Background
In order to counter the attractiveness of cigarettes, Article 11 of the Framework Convention on Tobacco
Control mentions the possibility of including a health warning on cigarettes. The objective of this study was toexplore perceptions of cigarettes designed to be dissuasive (either displaying a text health
warning or pictogram, unattractively coloured, or a combination of these).

Methods
In-depth interviews were conducted with 31 people in France aged 15-25 years (11daily smokers, 10 occasional smokers, 10 non-smokers, 15 females, 16 males). Participants were shown the different
dissuasive cigarettes (displaying the warning 'Smoking kills', a ‘skull and crossbones’ pictogram, unattractive shades of brown or green, or a combination of all three). Open-ended questions were asked about the attractiveness of the cigarettes, perception of risk, the image of the smoker, and influence on desire to quit or not to start. Discussions were audio-recorded and transcribed. Manual coding and « IRaMuTeQ » software was used to analyse the data.

Results
The different dissuasive elements used were found to increase negative health perceptions (e.g.  increase risk), reduce positive smoker image and the perceived pleasure of smoking (e.g. embarrassment of smoking in front of friends), decrease desire to start smoking and increase desire to quit. The most dissuasive cigarette was an unattractively coloured cigarette which displayed both the warning 'smoking kills' and 'skull and bones' pictogram.

Conclusion
This study highlights the importance of the appearance of the cigarette, and suggests that dissuasive
cigarettes may be an innovative tobacco control measure for governments.