The devastating southeast Asian tsunami of December 26, 2004 has brought home the destructive consequences of coastal hazards in an absence of effective warning systems. Since the 1946 tsunami that destroyed much of Hilo, Hawai'i, a network of pole mounted sirens has been used to provide an early public alert of future tsunamis. However, studies in the 1960s showed that understanding of the meaning of siren soundings was very low and that ambiguity in understanding had contributed to fatalities in the 1960 tsunami that again destroyed much of Hilo. The Hawaiian public has since been exposed to monthly tests of the sirens for more than 25 years and descriptions of the system have been widely published in telephone books for at least 45 years. However, currently there remains some uncertainty in the level of public understanding of the sirens and their implications for behavioral response. Here, we show from recent surveys of Hawai'i residents that awareness of the siren tests and test frequency is high, but these factors do not equate with increased understanding of the meaning of the siren, which remains disturbingly low (13%). Furthermore, the length of time people have lived in Hawai'i is not correlated systematically with understanding of the meaning of the sirens. An additional issue is that warning times for tsunamis gene rated locally in Hawai'i will be of the order of minutes to tens of minutes and limit the immediate utility of the sirens. Natural warning signs of such tsunamis may provide the earliest warning to residents. Analysis of a survey subgroup from Hilo suggests that awareness of natural signs is only moderate, and a majority may expect notification via alerts provided by official sources. We conclude that a major change is needed in tsunami education, even in Hawai'i, to increase public understanding of, and effective response to, both future official alerts and natural warning signs of future tsunamis.