<![CDATA[Background: Smoking is a unique social phenomenon among adolescents because it begins with high curiosity to try cigarettes and eventually develops into a habit that is difficult to stop. Objectives: This research aims to explore adolescents' perceptions of pictorial health warnings (PHWs) on cigarette packs. Method: This research is qualitative, using a purposive sampling technique with predetermined criteria. The population was male adolescents aged 10-19 years. This research involved 35 adolescents from Banjarmasin City, Banjarbaru City, and Tanah Bumbu Regency, South Kalimantan Province. Data were collected using an open-ended questionnaire. Results: The findings of this research can be grouped into several main thematic areas, namely perceptions of visual content, effectiveness of pictorial health warnings (PHWs), suggestions for improvement, emotional responses, and intensity of attention. Participants generally thought that the images displayed on cigarette packs should more explicitly highlight the health effects of smoking. Perceptions of the effectiveness of current PHWs varied, ranging from the view that PHWs are less attractive to quite effective in conveying health messages. Some of the suggestions that emerged included typographical changes, selection of more visually disturbing images, and the addition of elements such as information on medical costs, unappealing colors, and warnings about death. Regarding the intensity of attention to PHWs, participants' responses varied, ranging from not paying attention to seeing them frequently. Most participants believed that PHWs can influence adolescents' decisions not to smoke through emotional responses in the form of fear and concern about their impact. Conclusion: This research indicates that the effectiveness of PHWs on cigarette packs for adolescents is limited, and design improvements as well as cross-sector collaboration are needed to increase awareness of their impact.]]>
