Background: Smoking rates among very disadvantaged population groups remain high - oftenmore than twice the Australian general population smoking rate. Anti-tobacco TV ads are anintegral and effective part of general population tobacco control strategy, however limitedevidence suggests these ads may also have unintended consequences, acting as cues to smoke,with certain sub-groups of disadvantaged smokers. The impact of anti-smoking TV ads amongsocially disadvantaged smokers has not been adequately assessed, and there is a need for rigorousresearch using innovative methodology adapted to suit the needs of this population.Aims: To evaluate the relative perceived effectiveness of key anti-tobacco message typesamong a sample of highly socioeconomically disadvantaged smokers. Methods: Clientsseeking financial or material assistance from a Social and Community Service Organisationin NSW, Australia were invited to complete a touchscreen computer survey. Participants wereexposed to two of three types of anti-smoking advertisements (why-graphic; why-emotional;how), randomly selected and ordered for each participant. Participants were asked about theirresponses to the advertisements immediately after viewing.Results: N=400 smokers (76 % response rate) completed the survey (59 % female; mean age38 years). The smoking rate in this setting is 65 % (daily and occasional). Most respondents had not completed high school, three-quarters had an income of less than AUD$400/week, and 18 % identified as Indigenous Australian. Comparison of Why-graphic, Why-emotional and How-to-quit message types showed that socially disadvantaged smokers give more positive ratings to ‘why’ compared to ‘how’ ads. Ads using highly graphic visceral imagery, or highly emotive personal testimonial were rated similarly. Conclusions: Mass media advertisements using strong graphic imagery or emotive personal testimonials to convey the negative health consequences of smoking rated highly as effective amongst highly socially disadvantaged smokers.