SEPTEMBER 2014

CIGARETTEPACKAGEHEALTHWARNINGSINTERNATIONAL STATUS REPORT
FOURTH EDITIONLARGER, PICTURE HEALTHWARNINGS: THE GROWINGWORLDWIDE TRENDThis report – Cigarette Package Health Warnings:
International Status Report – provides an international
overview ranking 198 countries/jurisdictions basedon warning size, and lists those that have finalized
requirements for picture warnings. Regional breakdowns
are also provided. This report is in its fourth edition, withthe third edition dated October 2012.
There has been tremendous progress internationally in
implementing package warnings, with many countries
increasing warning size, more countries requiring picture
warnings, and an increasing number of countries requiring
two, three, four or even more rounds of picture warnings.
The worldwide trend for larger, picture health warnings is
growing and unstoppable, with many more countries in theprocess of developing such requirements.

• Fully 60 countries/jurisdictions have required warnings
to cover at least 50% of the packagefront and back (onaverage), up from 47 in 2012, 32 in 2010 and 24 in 2008.
• Progress since the last report in 2012 includes Thailand
increasing the size of picture warnings from 55% to 85%,
Nepal implementing 75% picture warnings, Jamaica
improving warnings from 33% text to 60% pictures, andUruguay implementing its 7th round of picture warnings(Uruguay’s size is 80%). In addition, the new EU Directive
will require picture warnings to cover the top 65% of the
package front and back, effective May 20, 2016. (Thisreport reflects existing EU requirements, not the pending
2016 improvements in the EU.)
• Here are the top countries in terms of warning size as anaverage of the front and back:Report highlights include:

1. 85% Thailand (85% of front, 85% of back)2. 82.5% Australia (75%, 90%)
3. 80% Uruguay (80%, 80%)
4. 75% Brunei (75%, 75%)
4. 75% Canada (75%, 75%)
4. 75% Nepal (75%, 75%)
7. 65% Togo (65%, 65%)
7. 65% Turkey (65%, 65%)
7. 65% Turkmenistan (65%, 65%)
10. 65% Mauritius (60%, 70%)
11. 65% Mexico (30%, 100%)
11. 65% Venezuela (30%, 100%)• Fully 77 countries/jurisdictions have now finalized picture
warning requirements, an increase from the 55 that had
implemented by the end of 2012. Canada was the first
country to implement picture warnings in 2001.
• Fully 49% of the world’s population is covered by the 77
countries/jurisdictions that have finalized picture warning
requirements.
• Thailand now has the largest warnings in the world at
85% of the package front and back, surpassing Australia
at 82.5% (75% front, 90% back). Australia (since 2012) has
also implemented plain packaging to prohibit tobaccocompany colours, logos, and design elements on thebrand part of the package. (Examples of Australianplain packages can be seen on the cover, and on
page 14.) Ireland, the United Kingdom, France, and
New Zealand are in the process of implementing plain
packaging, and the new European Union (EU) Directive
provides that the 28 EU countries have the option to
implement plain packaging.

Well-designed package warnings are a highly cost effectivemeans to increase awareness of the health effects and to
reduce tobacco use, as recognized by guidelines to implement Article 11 (packaging and labelling) adopted under
the WHO Framework Convention on Tobacco Control.
A picture says a thousand words. Pictures can convey amessage with far more impact than can a text-only message. For size, the effectiveness of warnings increases withsize. A larger size allows for bigger and better pictures, alarger font size, and/or additional information, including
cessation information.

INFORMATION COLLECTION
Considerable effort was made to ensure the accuracyof the information contained in this report. Information
obtained as of September 25, 2014, has been included toensure that the report was as up-to-date as possible before
publication. However, for a few countries, it was not possible to confirm national requirements prior to press time.
Moreover, national requirements for package warnings areconstantly evolving and, as such, it may be that for somecountries listed in this report further progress may havebeen made but is not reflected in this report.

2

Country information was only included in this report once
legal requirements (such as an Act, regulation, or decree)were finalized, and no further approval steps were needed. For some countries, the transition period for warning
implementation on packages has not been completed;however if no further approval steps were needed, these
new requirements were included in the report. Where new
information for a country could not be confirmed prior to
publication, this new information was not included.
This report provides information only for packages ofcigarettes, not other tobacco products. Information for
cigarette cartons has not been compiled.

COUNTRIES REQUIRING PICTURE WARNINGSAt least 77 countries/jurisdictions have finalized requirements for picture warnings. The listing below includes the year of implementation, including different years where there have been two or more rounds of picture warnings.
1.
2.
3.
4.
5.
6.
7.

Canada (2001; 2012)
Brazil (2002; 2004; 2009)
Singapore (2004; 2006; 2013)
Thailand (2005; 2007; 2010; 2014)
Venezuela (2005; 2009; 2014)
Jordan (2006; 2013)
Australia (2006, rotation of 2 sets every
12 months; 2012, rotation of 2 sets
every 12 months)
8. Uruguay (2006; 2008; 2009; 2010; 2012;2013; 2014)
9. Panama (2006; 2009; 2010; 2012; 2014)
10. Belgium (2006; rotation of 3 sets every
12 months starting 2011)
11. Chile (2006; 2007; 2008; 2009; 2010;2011; 2012; 2013) 9
12. Hong Kong (2007)
13. New Zealand (2008; rotation of 2 sets
every 12 months)
14. Romania (2008)
15. United Kingdom (2008)
16. Egypt (2008; 2010; 2012; 2014)17. Brunei (2008; 2012)
18. Cook Islands (2008) 2
19. Iran (2009)
20. Malaysia (2009; 2014)
21. Taiwan (2009; 2014)
22. Peru (2009; 2011; 2014)
23. Djibouti (2009)

THAILAND (FRONT)

24. Mauritius (2009)
25. India (2009; 2011; 2013)
26. Cayman Islands (2009)
27. Latvia (2010)
28. Pakistan (2010)
29. Switzerland (2010, rotation of 3 sets
every 24 months)
30. Liechtenstein (2010, rotation of 3 sets
every 24 months)
31. Mongolia (2010; 2013)
32. Colombia (2010; 2011; 2012; 2013; 2014)
33. Turkey (2010)
34. Mexico (2010; 2011; 2012; 2013; 2014)
35. Norway (2011)
36. Malta (2011)
37. France (2011)
38. Guernsey (2011)
39. Spain (2011)40. Bolivia (2011)41. Jersey (2012)
42. Ukraine (2012)
43. Honduras (2012) 11
44. Madagascar (2012; 2013)
45. Denmark (2012)
46. Ecuador (2012; 2014)
47. Argentina (2012; 2014)
48. El Salvador (2012; 2015)49. Bahrain (2012)
50. Kuwait (2012)

AUSTRALIA (FRONT)TURKEY (FRONT)

51. Oman (2012)
52. Qatar (2012)
53. Saudi Arabia (2012)
54. United Arab Emirates (2012)
55. Hungary (2012) 14
56. Macau (2013)
57. Iceland (2013)
58. Ireland (2013)
59. Russia (2013)
60. Kazakhstan (2013)
61. Seychelles (2013)
62. Fiji (2013)
63. Vietnam (2013)
64. Macedonia The F. Y. R. (2014) 18
65. Montenegro (2014) 18
66. Indonesia (2014)
67. Nepal (2014)
68. Costa Rica (2014)
69. Jamaica (2014)
70. Suriname (2014)
71. Yemen (2014)72. Sri Lanka (2015)73. Solomon Islands (2015)
74. Turkmenistan (2015)
75. Trinidad and Tobago (2015, rotationof 2 sets every 12 months)
76. Namibia (2015)77. Philippines (2015)

NEPAL (FRONT)BRUNEI (FRONT)REGIONAL BREAKDOWN FOR PICTURE-BASEDHEALTH WARNINGS
4 AFRICAN REGION (AFRO)

19

23

EUROPEAN REGION (EURO)
Belgium, Denmark, France, Guernsey, Hungary, Iceland,
Ireland, Jersey, Kazakhstan, Latvia, Liechtenstein,
Macedonia The F.Y.R., Malta, Montenegro, Norway,
Romania, Russia, Spain, Switzerland, Turkey,
Turkmenistan, Ukraine, United Kingdom

12

EASTERN MEDITERRANEAN REGION (EMRO)
Bahrain, Djibouti, Egypt, Iran, Jordan, Kuwait,
Oman, Pakistan, Qatar, Saudi Arabia, U.A.E., Yemen

AMERICAS REGION (AMRO)
Argentina, Bolivia, Brazil, Canada, Cayman Islands (UK),
Chile, Colombia, Costa Rica, Ecuador, El Salvador,
Honduras, Jamaica, Mexico, Panama, Peru, Suriname,
Trinidad and Tobago, Uruguay, Venezuela

Madagascar, Mauritius, Namibia, Seychelles

5

SOUTH EAST ASIAN REGION (SEARO)
India, Indonesia, Nepal, Sri Lanka, Thailand

14 WESTERN PACIFIC REGION (WPRO)
Australia, Brunei, Cook Islands, Fiji, Hong Kong (S.A.R.,
China), Macau (S.A.R., China), Malaysia, Mongolia, New
Zealand, Philippines, Singapore, Solomon Islands,
Taiwan,China, Vietnam

3

SIZE RANKINGS —AVERAGE OF PACKAGE FRONT AND BACKThis listing indicates the world leaders in terms of size as an average of the package front and back – only thosecountries exceeding 50% on average are listed here (a full table begins on page 8). For each country there is indicatedin parentheses the size (including a border, if required) on the front, followed by the back. For example (60%, 70%)means 60% of front and 70% of back.
85% Thailand (85%, 85%)
82.5% Australia (75%, 90%) 1
80% Uruguay (80%, 80%)
75% Brunei (75%, 75%)
75% Canada (75%, 75%)
75% Nepal (75%, 75%)
65% Togo (65%, 65%)
65% Turkey (65%, 65%)
65% Turkmenistan (65%, 65%)

URUGUAY (FRONT)

65%
65%
65%
60%
60%
60%
60%
60%
60%

SWITZERLAND (BACK)

Mauritius (60%, 70%)
Mexico (30%, 100%)
Venezuela (30%, 100%)
Ecuador (60%, 60%)
Jamaica (60%, 60%)
Sri Lanka (60%, 60%)
Cook Islands (30%, 90%) 2
Fiji (30%, 90%)
New Zealand (30%, 90%)

VIETNAM (FRONT)

56%
56%
56%
56%
55%
52%
52%
52%
50%

Namibia (51%, 61%)
Belgium (48%, 63%)
Liechtenstein (48%, 63%)
Switzerland (48%, 63%)
Malaysia (50%, 60%)
Kyrgyzstan (52%, 52%)
Finland (45%, 58%)
Ireland (45%, 58%)
34 countries/jurisdictions

CANADA (FRONT)REGIONAL BREAKDOWN — LARGEST SIZES BYREGION (AVERAGE OF FRONT/BACK)For each country there is indicated in parentheses the size (including a border, if required) on the front, followed by the
back. For example (30%, 90%) means 30% of front and 90% of back.
South East Asian Region (SEARO)
85% Thailand (85%, 85%)
75% Nepal (75%, 75%)
60% Sri Lanka (60%, 60%)
40% Indonesia (40%, 40%)

4

Eastern Mediterranean Region(EMRO)
50% Bahrain (50%, 50%)
50% Djibouti (50%, 50%)
50% Egypt (50%, 50%)
50% Iran (50%, 50%)
50% Kuwait (50%, 50%)
50% Oman (50%, 50%)
50% Qatar (50%, 50%)
50% Saudi Arabia (50%, 50%)
50% U.A.E. (50%, 50%)
50% Yemen (50%, 50%)

Western Pacific Region (WPRO)
82.5% Australia (75%, 90%)
75% Brunei (75%, 75%)
60% Cook Islands (30%, 90%) 2
60% Fiji (30%, 90%)
60% New Zealand (30%, 90%)
55% Malaysia (50%, 60%)
50% 7 countries/jurisdictions

Americas Region (AMRO)
80% Uruguay (80%, 80%)
75% Canada (75%, 75%)
65% Mexico (30%, 100%)65% Venezuela (30%, 100%)60% Ecuador (60%, 60%)
60% Jamaica (60%, 60%)
50% 11 countries/jurisdictions

European Region (EURO)
65% Turkey (65%, 65%)
65% Turkmenistan (65%, 65%)
56% Belgium (48%, 63%)
56% Liechtenstein (48%, 63%)
56% Switzerland (48%, 69%)

African Region (AFRO)
65% Togo (65%, 65%)
65% Mauritius (60%, 70%)
56% Namibia (51%, 61%)
50% Cameroon (50%, 50%)
50% Ghana (50%, 50%)
50% Madagascar (50%, 50%)
50% Seychelles (50%, 50%)

COUNTRIES/JURISDICTIONS REQUIRING PICTURE
WARNINGS ON CIGARETTE PACKAGES
80
70

63

60

70

77

55

50
40

34
26

30
20
10
0

FIJI (BACK)

40

2

1

2

3

5

11

12

18

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

NEW ZEALAND (BACK)JAPAN (FRONT)PANAMA (FRONT)COSTA RICA (BACK)SIZE RANKINGS — FRONT OF PACKAGE
This listing indicates the world leaders in terms of the largest size for the front of the package. Warnings located on thefront of the package are more visible than on the back.
85%
80%
75%
75%
75%
75%
70%
65%
65%
65%
60%
60%
60%
60%
52%
51%
50%
50%

Thailand
Uruguay
Australia
Brunei
CanadaNepal
Solomon Islands
Togo
TurkeyTurkmenistan
EcuadorJamaica
Mauritius
Sri Lanka
Kyrgyzstan
Namibia
Albania
Argentina

50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%

Bahrain
Bolivia
Cameroon
Chile
Cost Rica
Djibouti
Egypt
El Salvador
Ghana
HondurasHong Kong (S. A. R. China)
Iran
Kuwait
Libya
Macau (S. A. R. China)
Madagascar
Malaysia
Mongolia

50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
48%
48%
48%

Oman
PanamaPeru
Philippines
Qatar
Saudi Arabia
Seychelles
Singapore
Suriname
Trinidad and Tobago
UkraineUnited Arab Emirates
Vietnam
Yemen
Belgium
Liechtenstein
Switzerland

5

50%+
COUNTRIES/JURISDICTIONSREQUIRING WARNINGS OF
AT LEAST 50% OF PACKAGEFRONT/BACK (ON AVERAGE)

70

60

60

46

50

40

30

32
24

20
10

0

30%+
COUNTRIES/JURISDICTIONSREQUIRING WARNINGS ON
AT LEAST 30% OF PACKAGEFRONT/BACK (ON AVERAGE)

2008

2010

2012

140

119

120

134

95

100
80

2014

68

60
40
20
0

2008

2010

2012

2014

OBLIGATIONS UNDER THE WHO FRAMEWORKCONVENTION ON TOBACCO CONTROL
Pursuant to Article 11 of the WHO Framework Convention
on Tobacco Control (FCTC), the international tobacco
treaty, Parties to the Convention must require that all
packages of tobacco products carry health warnings
describing the harmful effects of tobacco use or otherappropriate messages which “should be 50% or moreof the principal display areas but shall be no less than
30% of the display areas” and may be in the form of or
include picture warnings. For most cigarette packages,
the “principal display areas” are the front and back of
the package. Warnings must be in the national languageor languages, must be rotated (a single warning is
insufficient), must apply to cartons and other outer
packages sold to consumers, and must be applied to all
categories of tobacco products. Non-health messages(e.g. “Quit, save money”) may be included. Under the
FCTC, no exceptions are allowed for duty-free stores, or forsmall volume brands. Each Party must implement warning

6

requirements pursuant to Article 11 within three years after
the FCTC comes into force for that Party.
Article 11 also has a provision regarding emission
information elsewhere on the package, with the
Article 11 Guidelines42 providing that qualitative
information should be used without tar and nicotine
ISO yield numbers. Further, Article 11 requires Parties
to ensure that the industry’s use of the package is not“false, misleading, deceptive or likely to create anerroneous impression” – accordingly a growing numberof countries have prohibited “light”, “mild” and othermisleading descriptors.

EFFECTIVENESS OF WARNINGS
INCREASES WITH LARGER SIZE,USE OF PICTURES
Health warnings on packages of tobacco products are ahighly cost-effective means of health communication. Package warnings reach every smoker (and consumers of othertobacco products) every day. Warnings are always working— 24 hours per day, 7 days per week. A pack a day smoker
would take his or her pack out 20 times per day, 7300 times
per year. Warnings are also seen by those around the consumers, such as family, friends and co-workers.
Effective package warnings increase awareness of thehealth effects and reduce tobacco use. As a result of healthwarnings, consumers receive more information, not less.
Consumers are entitled to be fully informed of the many
health effects of tobacco products, and the package is thebest way to do that. Studies show that consumers, including children, underestimate the health effects, inlow, middle and high income countries.
Health departments determine the content of warnings,
but the tobacco industry pays the cost. With such an
extraordinary reach, it is not surprising that so many governments are improving package warning requirements.
The tobacco industry opposes larger, picture warnings as
a way to protect sales volumes — if such warnings would
not work, then why is the industry so often opposed? Anabundance of research studies41 as well as country experience provide overwhelming evidence about the beneficial
impact of larger, picture warnings.

LARGER SIZE IS MORE EFFECTIVE
The FCTC Article 11 guidelines42 recognize that theeffectiveness of health warnings increases with size,
and that “Parties should consider […] more than 50%”and “aim to cover as much of the principal display areas
as possible”.
A larger size means that warnings are more visible, more
important, and have more impact. A larger size allows
for bigger and better pictures, a larger font size and/or
additional information, including cessation information.
Further, a larger size makes it more difficult for the branded
promotional part of the package to distract the consumer’s
attention away from the warning. That larger sizes are
more effective is confirmed by the considered decisions ofgovernments worldwide where the trend is very much toincrease warning size.

A PICTURE SAYS A THOUSAND WORDS
Pictures can convey a message with far more impact
than can a text-only message. A picture really does saya thousand words. Pictures are particularly significant forindividuals who are illiterate or who have low literacy, an
aspect especially important in many countries. Pictures arealso important to immigrants, temporary workers as wellas individuals from minority language groups who may not
yet be able to read the national language(s).

Where tobacco advertising is not yet banned, tobaccocompanies use colour pictures in tobacco advertising. Further, the tobacco industry has often printed colour pictures
on packages. If tobacco companies have used pictures topromote tobacco products, then governments should be
able to use pictures to discourage tobacco use.
The feasibility of implementing picture warnings has
been demonstrated in more than 70 countries/jurisdictions. If these countries can do it, then all countries can.
It is notable that often in the very same cigarette factorysome packages have picture warnings and some do not,depending on the country of destination.
To ensure better visibility and impact, picture warnings
should be placed on both the front and back of the package (not just one of these), and should be placed at the
top of the front/back, not the bottom, as provided in the
Article 11 Guidelines.42 The table on pages 8–11 lists sizes
for both the package front and back, recognizing that thefront is more important due to greater its visibility.

PLAIN PACKAGING
Plain packaging would prohibit brand colours, logos
and design elements on packages, and would requirethat packages only come in a standard shape and format.
Under plain packaging, health warnings would continue
to appear, but the brand portion of the package would
have the same colour (e.g. brown) for all brands. The brandname would be allowed on packages, but only in a standard location, colour (e.g. black), font style and size.
Plain packaging would curb the industry’s use of the package as a promotional vehicle, would increase the effectiveness of package warnings, would curb package deception,
and would decrease tobacco use. Both the Article 1142
and the Article 1343 guidelines under the FCTC recommend that Parties consider implementing plain packaging.
Australia’s world precedent setting plain packaging had full
implementation at the retail level as of December 1, 2012.
There is tremendous international momentum on plain
packaging, including these recent developments:
Australia – Plain packaging legislation adopted December 1, 2011
and fully implemented December 1, 2012.44 Constitutional challenge
dismissed by High Court of Australia August 15, 2012.45
Ireland – Government Bill introduced in Parliament June 11, 2014.46
United Kingdom – Enabling legislation approved by Parliament
March 13, 2014.47 Draft implementing regulations published
June 26, 2014 with consultation that ended August 7, 2014.48
New Zealand – Government Bill introduced December 17, 2013, firstreading February 11, 2014, Health Committee approval Aug. 5, 2014.49
France - Health Minister announced Sept. 25, 2014 bill to be introduced.
Finland – Government national action plan (June 2014) includes plain
packaging as planned measure.50
European Union – new Tobacco Products Directive adopted
April 3, 2014 explicitly states that 28 EU countries have optionof implementing plain packaging.51

7

8

G
S
IN
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PI
C
Y E TU
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PI

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SD Y/
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A AR
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FR
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M SS BEIN TH RIM A S T
U N 3 AT
M 0 E
SI % S
A
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RT
FC IC
TC LE
D 11
EA
D
LI
N
E

INTERNATIONAL RANKINGS

1
2

1 Thailand
2 Australia (1)√ 85 85√ 82.5 758590

2005, 2007, 2010, 2014
2006, 20123

3 Uruguay

√

80

80

80

2006, 2008, 2009, 2010,2012, 2013, 2014

4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

4
4
4
7
7
7
10
11
11
13
13
13
16
16
16
19
20
20
20
23
24
25
25
27
28
28
28
28
28

√
√
√

75
75
75
65
65
65
65
65
65
60
60
60
60
60
60
56
56
56
56
55
52
52
52
50
50
50
50
50
50

75
75
75
65
65
65
60
30
30
60
60
60
30
30
30
51
48
48
48
50
52
45
45
70
50
50
50
50
50

75
75
75
65
65
65
70
100
100
60
60
60
90
90
90
61
63
63
63
60
52
58
58
30
50
50
50
50
50

33

28 Chile (9)

√

50

50

50

34
35
36
37
38
39
40
41
42
43
44
45
46
47

28
28
28
28
28
28
28
28
28
28
28
28
28
28

√
√
√
√

50
50
50
50
50
50
50
50
50
50
50
50
50
50

50
50
50
50
50
50
50
50
50
50
50
50
50
50

50
50
50
50
50
50
50
50
50
50
50
50
50
50

Brunei
CanadaNepal
Togo
TurkeyTurkmenistan
Mauritius
MexicoVenezuela
EcuadorJamaica
Sri Lanka
Cook Islands (2)Fiji
New Zealand (3)Namibia (4)Belgium (5)Liechtenstein (6)Switzerland (7)Malaysia
Kyrgyzstan (8)Finland
Ireland
Solomon Islands
Albania
Argentina
Bahrain
Bolivia
Cameroon

Costa Rica
Djibouti
Egypt
El Salvador
Ghana (10)Honduras (11)Hong Kong (S.A.R., China)
Iran
KuwaitMacau (S.A.R., China)
Madagascar
Mongolia
Oman
Panama

√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√

√
√
√
√
√

√
√
√
√
√
√
√
√
√

2008, 2012
2001, 2012
2014

√
*
*

#
#

√
√

2010
2015
2009
2010, 2011, 2012, 2013, 2014
2005, 2009, 20142012, 2014
2014
2015
2008
2013
2008
2015
2006, 2011
2010
2010
2009, 2014

2013
2015
#

2012, 2014
2012
2011
2006, 2007, 2008, 2009,2010, 2011, 2012, 2013

#

#

#

2014
2009
2008, 2010, 2012, 20142012, 2015
2012
2007
2009
2012
2013
2012, 20132010, 20132012
2006, 2009, 2010, 2012, 2014

√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√

√
√
√

√

√
√

√

50
50
50
50
50
50
50
50
50
50
50
50
50
48
48
48
48
48
48
48
48
48
48
48
48
48
48
45
43
43
43
40
40
40
40
40
40
40
39
39
39
39
39
35
35
35
35
35
35

50
50
50
50
50
50
50
50
50
50
50
50
0
43
43
43
43
43
43
43
43
43
43
43
43
43
43
45
43
43
35
40
40
40
40
40
30
30
32
32
32
32
32
35
30
30
30
30
30

50
50
50
50
50
50
50
50
50
50
50
50
100
53
53
53
53
53
53
53
53
53
53
53
53
53
53
45
43
43
50
40
40
40
40
40
50
50
45
45
45
45
45
35
40
40
40
40
40

G
S
IN
RN
PI
C
Y E TU
A RE
R( W
S) A

C

Peru
Philippines
Qatar
Saudi Arabia
Seychelles
Singapore
Suriname
Trinidad and Tobago
UkraineUnited Arab Emirates
Viet Nam
Yemen
Brazil (12)Estonia
FranceGuernsey (13)Hungary (14)IcelandJersey (13)LatviaNorwayPortugal
Romania
Slovenia
Spain
SwedenUnited Kingdom
Lebanon (15)Jordan (16)Nigeria (17)Bosnia and Herzegovina
Comoros
Indonesia
Kazakhstan
PakistanUzbekistan
Kenya
Russian Federation
CyprusGreenland (Denmark)KosovoLuxembourg
Malta
Taiwan, China
Austria
Bulgaria
Croatia
Czech Republic
Denmark

N

48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96

PI

CO
JU UN
R I TR
SD Y/
IC
TI
O

28
28
28
28
28
28
28
28
28
28
28
28
60
61
61
61
61
61
61
61
61
61
61
61
61
61
61
75
76
76
78
79
79
79
79
79
84
84
86
86
86
86
86
91
92
92
92
92
92

K
RA

N

TU
AV RE
ER W
A AR
G
FR
E NIN
FR
O
N
O GS
T
N
BA
T/
CK
BA
CK
EC
M
LE E M
M SS BEIN TH RIM A S T
U N 3 AT
M 0 E
SI % S
A
ZE
RT
FC IC
TC LE
D 11
EA
D
LI
N
E

# Countries/jurisdictions that are not Parties to the FCTC
* Countries/juridisctions that follow the EC

2009, 2011, 2014
2015
2012
2012
2013
2004, 2006, 2013
2014
2015
2012
2012
2013
2014
2002, 2004, 2009
√
√
*
√
*
*
√
*
√
√
√
√
√
√

2011
2011
2012
2013
2012
2010
2011
2008
2011
2008
2006, 2013

*
#

2014
2013
2010

2013
√
*
√
√

#
#

#
√
√
√
√
√

2011
2009, 2014

2012

9

Faroe Islands (Denmark)Germany
GreeceItaly
Lithuania
Macedonia, The F.Y.R. (18)
Moldova, Republic ofMontenegro (18)Netherlands
PolandSan Marino (19)SerbiaSlovakia
Armenia
Bangladesh
Belarus
Benin
Cambodia
China
Colombia
Congo, Republic of
D. R. Congo
Eritrea (20)GambiaGeorgia
GuineaIsraelJapan
Lao P.D.R.
Maldives
Mali
Nauru
South Korea (Republic of Korea)
Tonga
UgandaCuba (21)
Mozambique
Libya
South Africa (22)India
Zimbabwe
Algeria
Cayman Islands (UK) (23)
GuatemalaWest Bank and Gaza Strip
Morocco (24)Zambia (25)AfghanistanAndorra (26)AngolaAntigua and Barbuda
BahamasBarbados

√
√

√

√

√

35
35
35
35
35
35
35
35
35
35
35
35
35
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
28
25
21
20
20
15
15
13
10
5
3
0
0
0
0
0
0

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
0
30
50
16
40
15
15
0
25
20
0
3
0
0
0
0
0
0

40
40
40
40
40
40
40
40
40
40
40
40
40
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
60
25
0
26
0
25
15
30
0
0
10
3
0
0
0
0
0
0

*
√
√
√
√
*
*
*
√
√
*
*
√

G
S
IN
N
PI
C
Y E TU
A RE
R( W
S) A
R

C
TU
AV RE
ER W
A AR
G
FR
E NIN
FR
O
N
O GS
T
N
BA
T/
CK
BA
CK
EC
M
LE E M
M SS BEIN TH RIM A S T
U N 3 AT
M 0 E
SI % S
A
ZE
RT
FC IC
TC LE
D 11
EA
D
LI
N
E

PI

N

92
92
92
92
92
92
92
92
92
92
92
92
92
110
110
110
110
110
110
110
110
110
110
110
110
110
110
110
110
110
110
110
110
110
110
132
133
134
135
136
137
138
139
140
141
142
143
144
144
144
144
144
144

CO
JU UN
R I TR
SD Y/
IC
TI
O

K
N
RA

10

97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149

#

2014

2010, 2011, 2012, 2013, 2014

#

X
X
X
X
X

X
X
X
X
X
X

#
#
Sep. 5, 2008
Jul. 18, 2008
Feb. 27, 2008#
Sep. 28, 2009#
Feb. 14, 2009##
Aug. 21, 2011
Nov. 11, 2013#
Dec. 19, 2010
Sep. 3, 2009
Feb. 1, 2013
Feb. 1, 20092009, 2011, 2013

2009

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

X

X
X
X
X
X
X
X
X
X
X

Mar. 15, 2009
Feb. 27, 2008
May. 1, 2008
Oct. 29, 2009
Feb. 20, 2009
Jan. 2, 2009
Feb. 5, 2009
Apr. 30, 2009
Nov. 11, 2013
Aug. 14, 2008
Oct. 22, 2009#
Dec. 16, 2008
May. 21, 2012
Nov. 12, 2010
Feb. 5, 2012
Dec. 14, 2008#
Dec. 14, 2008
Apr. 14, 2008
Dec. 14, 2012#
Mar. 8, 2008
Jan. 26, 2009
Jun. 16, 2008#
Feb. 27, 2008
Jul. 8, 2011
Aug. 25, 2008
Sep. 1, 2008
Feb. 27, 2008
Aug. 23, 2009
Dec. 2009
Jan. 17, 2009
Sep. 19, 2014
Feb. 5, 2009

186 144 St Vincent and the Grenadines

0

0

0

X

Jan. 27, 2014

187
188
189
190
191
192
193
194
195
196
197
198

0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0

X
X
X
X

Feb. 1, 2009
Jul. 11, 2009
Apr. 27, 2008
Aug. 20, 2012#
Jan. 29, 2009
Apr. 13, 2009
Jul. 29, 2010
Sep. 5, 2013
Dec. 25, 2008#
Dec. 15, 2008

144
144
144
144
144
144
144
144
144
144
144
144

Samoa (32)
Sao Tome and Principe
Senegal (33)Sierra Leone
South Sudan
Sudan
Swaziland
Tanzania
Tunisia
TuvaluUnited States of America
Vanuatu (34)

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X

G
S
IN
RN
PI
C
Y E TU
A RE
R( W
S) A

TU
AV RE
ER W
A AR
G
FR
E NIN
FR
O
N
O GS
T
N
BA
T/
CK
BA
CK
EC
M
LE E M
M SS BEIN TH RIM A S T
U N 3 AT
M 0 E
SI % S
A
ZE
RT
FC IC
TC LE
D 11
EA
D
LI
N
E

N

C

BelizeBhutan (27)
Botswana
Burkina Faso (28)BurundiCape VerdeCentral African Republic
ChadCôte d'Ivoire
D.P.R. Korea
Dominica
Dominican Republic
Equatorial Guinea
Gabon (29)GrenadaGuinea-Bissau
GuyanaHaiti
Kiribati
LesothoLiberia
MalawiMarshall Islands
Mauritania
Micronesia
Monaco (30)
MyanmarNicaragua
Niger (31)
Niue
Palau
Papua New Guinea
Paraguay
RwandaSaint Kitts and Nevis
Saint Lucia

PI

N
CO
JU UN
R I TR
SD Y/
IC
TI
O

144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144
144

K
RA

150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185

In the table, the indicated average size for the front and back has been rounded; for example 17.5% appears as 18%. In the case ofAustralia, the average size has not been rounded.
Other countries: The following countries are not listed in this report (7): Azerbaijan, Ethiopia, Iraq, Syrian Arab Republic, Tajikistan,
Somalia, Timor-Leste.

11THE NEW EUROPEAN UNION DIRECTIVE
A new European Union Directive adopted April 3, 2014
will require all 28 EU countries to implement picture
warnings covering the top 65% of the package front
and back effective May 20, 2016 at the manufacturer
level.35 These pending requirements are not reflected inthis report. Although the European Commission has not
yet determined the content of new picture warnings, anillustrative mock-up for the pending new 65% warnings
is shown at right.

Source: European Commission

THE EXISTING EUROPEAN UNION DIRECTIVE —EXPLANATORY COMMENTFor EU countries, this report reflects implementationof the existing EU Directive. The existing EU Directive,
adopted in 2001, specifies that the warning size is to be
as follows, plus a border (3-4mm in width) that is to be inaddition to the space for the warnings:
35% (30% front, 40% back) unilingual countries
39% (32% front, 45% back) bilingual countries36
43% (35% front, 50% back) trilingual countries.37
Once the required border is factored in, the required
size in effect increases to the following:38
48% (43% front, 53% back), unilingual countries
52% (45% front, 58% back), bilingual countries
56% (48% front, 63% back), trilingual countries.

Many EU countries are not compliant with the EU
Directive that requires the border to be in addition to
the warning. Packages were able to be collected fromall 28 EU countries to assess compliance. Based on
this review, 13 of these 28 EU countries appear to be incompliance with the Directive in this respect,39 while 15of 28 are not in compliance because packages indicatethat the border has been included in the space forthe warning, instead of in addition to the warning.40 A
limitation of this is that the assessment is based on the
packaging material received, and not a comprehensive
examination of all brands sold on the market in eachcountry. In the EU, 10 of 28 countries have finalized
requirements for picture warnings.

NOTES

12

1. Australia : Rotation of two sets of 7 warnings every 12 months, for both 2006 and 2012 rounds. In addition to the 90% warning on the
package back, Australia also requires a fire risk statement, which appears on the bottom 10% of the package back.
2. Cook Islands : Warnings are to either comply with the Australian or New Zealand requirements (which include pictures), or to require
50% text warnings with specified messages in English and in Cook Islands Maori. In practice, packages have contained pictures as
required in Australia/New Zealand.
3. New Zealand : Rotation of two sets every 12 months.
4. Namibia : 50% front, 60% back, plus a border of unspecified size.
5. Belgium : Rotation of one of three sets every 12 months starting 2011.
6. Liechtenstein : Rotation of one of three sets every 24 months. Liechtenstein is in a customs union with Switzerland. Liechtenstein law
requires that tobacco packages depict Switzerland’s health warnings.
7. Switzerland : Rotation of one of three sets every 24 months.
8. Kyrgyzstan : Size includes a black border.
9. Chile : From 2006 to 2012 inclusive, Chile required only one picture warning to appear at a time on all packages, with the warningchanged every 12 months. Effective 2013, Chile required a series of warnings to appear concurrently.
10. Ghana : Warnings are in place through mandatory contractual arrangements between Ghana’s Food and Drug Board and tobacco
importers/distributors.
11. Honduras : Details of additional rounds of picture warnings were not fully obtained at press time.
12. Brazil : 100% of either front or back. A series of 30% text warnings is to be added to the package front effective January 1, 2016,
but the content of these front warnings has not yet been specified.
13. Guernsey, Jersey : Guernsey and Jersey are Crown dependencies located in the English Channel that are neither part of the UK
nor part of the EU.
14. Hungary : 42 picture warnings are to be rotated over 3 years, with the difference between the most and least frequently appearing
warnings not allowed to be more than 10%.
15. Lebanon : Size is 40% plus a border, with size estimated based on available packs. The Decree provides for a maximum border widthof 3mm, provides no minimum, and provides a mockup with a 3mm width.
16. Jordan : Size is 40% plus a border as illustrated in the national standard.

17. Nigeria : Size includes a border as illustrated in the national standard.
18. Macedonia The F.Y.R. and Montenegro : Year of implementation may have been prior to 2014.
19. San Marino : Cigarettes are imported from Italy and follow Italian package warning requirements.
20. Eritrea : The Proclamation to Provide for Tobacco Control provides that warnings shall be 30% or more, and should be 50% or more, ofthe package front and back. Packages obtained indicate that at least some brands have warnings larger than 30%.
21. Cuba : Warnings may appear on either 30% of both the front and back, or 60% of one of the front or back. Packages obtained depict
warnings on 60% of the back.
22. South Africa : 15% front, 25% back plus a border of unspecified width.
23. Cayman Islands : Regulations require a graphic health warning to appear on either front or back. The size shall be at least 30%, and noless than the size required by the country of origin.
24. Morocco : Size estimated based on available packs. Legislation requires a warning on the back, but does not specify a minimum size.
25. Zambia : Size estimated based on available packs. Legislation requires a warning on the front and back, but does not specify
a minimum size.
26. Andorra : In practice, packages tend to depict picture warnings from France or Spain.
27. Bhutan bans tobacco product sales, but allows importation by individuals of limited quantities for personal consumption provided
certain conditions are met, including that the packaging containing a health warning (no minimum warning size specified).
28. Burkina Faso : Decree No. 2011-1051/PRES/PM/MS/MEF on packaging and labelling of tobacco products in Burkina Faso, approved
December 30, 2011, contemplates picture warnings covering 60% of the package front and back, but the content of warnings has not
yet been specified.
29. Gabon : Law No. 006/2013 of August 21, 2013 concerning the enactment of measures supporting the campaign for tobacco control in
the Republic of Gabon, published in the Official Journal of September 24-30, 2013, requires that text messages on 60% of front and
65% of back effective 12 months after promulgation, but there have been implementation delays.
30. Monaco : In practice, packs follow France requirements.
31. Niger : Decision No. 442 MSP/DGSP/DHP/ES of December 2, 2013 regulating the composition, packaging and labelling of tobacco
products in Niger provides that picture warnings are to cover 50% of the package front and back, but the picture content has not yet
been specified.
32. Samoa : Tobacco Control Regulations 2013, dated October 29, 2013, provide that picture warnings are to cover 30% of front and 90%
of back effective July 1, 2014, but there have been implementation delays.
33. Senegal : Law No. 2014-14 concerning the manufacture, packaging, labelling, sale and use of tobacco, dated March 28, 2014, provides
that picture warnings are to cover at least 70% of the front and back, but a decree specifying the content of warnings has not yet
been adopted.
34. Vanuatu : Tobacco Control Regulation Order No. 86 of 2013, dated July 1, 2013, requires picture warnings on 50% of the front and back,effective 12 months after publication in the Gazette, but there have been implementation delays.
35. EU : Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014 on the approximation of the laws, regulations
and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco and related
products and repealing Directive 2001/37/EC.
36. EU : Bilingual EU Member States are Cyprus, Finland, Ireland, Luxembourg, Malta.
37. EU : Belgium is a trilingual EU Member State. Switzerland, Bosnia and Herzegovina, and Liechtenstein are non-EU countries that
require trilingual warnings with EU size requirements.
38. EU : The overall size including the border may vary depending on the package format (e.g. the overall size increases on smaller
packages, and on Superslims packages).
39. EU : Proper implementation of border/size requirement (13): Belgium, Estonia, Finland, France, Hungary, Ireland, Latvia, Portugal,
Romania, Slovenia, Spain, Sweden, United Kingdom. The following non-EU countries/jurisdictions have also implemented the EU
Directive, and have done so properly in terms of the border: Guernsey, Iceland, Jersey, Liechtenstein, Norway, Switzerland.
40. EU : Non-compliant with border/size requirement (15): Austria, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Germany, Greece,
Italy, Lithuania, Luxembourg, Malta, Netherlands, Poland, Slovakia. The following non-EU countries/jurisdictions have also implemented the EU Directive, but are non-compliant in terms of the border: Bosnia and Herzegovina, Faroe Islands, Kosovo, Macedonia The
F.Y.R., Moldova, Montenegro, San Marino, Serbia.
41. See Tobacco Labelling Resource Centre, www.tobaccolabels.org
42. Guidelines for implementation of Article 11 of the WHO Framework Convention on Tobacco Control (Packaging and labelling of
tobacco products).
43. Guidelines for implementation of Article 13 of the WHO Framework Convention on Tobacco Control (Tobacco advertising, promotion
and sponsorship).

NOTES FOR PLAIN PACKAGING
44. Australia : Tobacco Plain Packaging Act 2011, No. 148, 2011; Trade Marks Amendment (Tobacco Plain Packaging) Act 2011,
No. 149, 2011.
45. Australia : JT International SA v Commonwealth of Australia [2012] HCA 43, High Court of Australia, Order August 15, 2012,
Reasons October 5, 2012.
46. Ireland : Public Health (Standardised Packaging of Tobacco) Bill 2014, Bill Number 54 of 2014, introduced in the Seanad (Senate)
June 11, 2014. Second Stage in the Seanad approved June 17, 2014.
47. United Kingdom : Children and Families Act 2014, 2014 no. 6, section 94.
48. United Kingdom Department of Health, Welsh Government, Scottish Government, Northern Ireland Department of Health,Social Services and Public Safety, “Consultation on the introduction of regulations for standardised packaging of tobacco
products” published June 26, 2014.
49. New Zealand : Smoke-free Environments (Tobacco Plain Packaging) Amendment Bill, Bill 186-1, introduced December 17, 2013,
first reading Feb. 11, 2014; Health Committee Report, August 5, 2014.
50. Finland : Action plan to make the country smoke-free by 2040.
51. EU : Directive 2014/40/EU, note 35 above, Article 24(2).

13

URUGUAY (FRONT)THAILAND (FRONT)MALAYSIA (FRONT)URUGUAY (BACK)CANADA (FRONT)MONGOLIA (FRONT)AUSTRALIA (FRONT)BEFORE PLAIN PACKSCHINA (FRONT)

MAURITIUS (FRONT)BELGIUM (CARTON)KAZAKHSTAN (FRONT)AUSTRALIA (FRONT)DJIBOUTI (FRONT)KUWAIT/GCC (FRONT)AUSTRALIA (BACK)HUNGARY (BACK)

MAURITIUS (CARTON)

FOR MORE INFORMATION

14

Tobacco Labelling Resource Centre
www.tobaccolabels.org

World Lung Foundation
http://67.199.72.89/packwarning/pw_index.html

Tobacco Control Laws
www.tobaccocontrollaws.org

FCTC Guidelines for Article 11 (packaging and labelling)
http://www.who.int/fctc/guidelines/adopted/article_11/en/

Physicians for a Smoke-free Canada
www.smoke-free.ca/warnings

WHO Framework Convention on Tobacco Control
http://www.who.int/fctc

Campaign for Tobacco-Free Kids
http://global.tobaccofreekids.org/en/solutions/international_issues/warning_labels/

WHO warnings databasewww.who.int/tobacco/healthwarningsdatabase/en/index.html

JAMAICA (FRONT)JAMAICA (BACK)TOGO (BACK)VIETNAM (FRONT)COSTA RICA (FRONT)PANAMA (FRONT)INDONESIA (FRONT)INDIA (FRONT)COMOROS (FRONT)IRAN (FRONT)JORDAN (BACK)KAZAKHSTAN (FRONT)GREENLAND (BACK)CANADA (FRONT)MEXICO (FRONT)NEW ZEALAND(FRONT)NEW ZEALAND(BACK)RUSSIA (FRONT)RUSSIA (BACK)OMAN/GCC(WATERPIPE)

EGYPTHONDURASCOLOMBIA (2013)

MEXICO (2013)15

SUGGESTED CITATION
Canadian Cancer Society, Cigarette Package Health Warnings: International
Status Report, Fourth Edition, September 2014.

ACKNOWLEDGEMENT
The collaboration of the Framework Convention Alliance in the preparationof this report is much appreciated. The information in this report has
primarily been compiled by the Canadian Cancer Society, with further
contributions from the World Health Organization Tobacco Free Initiative,
the Campaign for Tobacco-Free Kids, and the Framework Convention
Alliance. Individuals from around the world gave of their time to provide
information, assistance which is gratefully acknowledged.

www.fctc.org