Background As recommended by WHO in the fight against smoking, the French authorities have decided to implement the display of 14 “shock pictures” on cigarette packages in 2011. This study examines the effectiveness of this policy. Methods The present study is based on a self-reported questionnaire administered to a sample of 418 first-year medical students from a private faculty in January 2010. We consider a set of 12 European visual warnings that address different smoking problems. Econometric modeling is used to study the determinants of answers. Results Our results were twofold. Firstly, the most effective symbols concern the smoker himself/herself, they are explicit and related to an advanced stage of disease. Secondly, the warnings s...