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RESEARCH PAPER
Tobacco packaging and labelling policies
in countries of the Eastern Mediterranean and Western Pacific Regions:
Post-deadline assessment of the time-bound measures of WHO FCTC Article 11
1
Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2
World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
Submission date: 2016-08-30
Final revision date: 2016-11-02
Acceptance date: 2016-11-07
Publication date: 2016-11-16
Corresponding author
Aya Mostafa
Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, 38 Ramses street, Abbassia Square, 11566 Cairo, Egypt
Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, 38 Ramses street, Abbassia Square, 11566 Cairo, Egypt
Tob. Prev. Cessation 2016;2(November):78
KEYWORDS
Packaging and labellinghealth warningsWHO FCTCtobacco control legislationsEastern Mediterranean RegionWestern Pacific Region
TOPICS
ABSTRACT
Introduction:
Article 11 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) forms the basis for regulation of tobacco product packaging and labelling. Countries are required to implement these measures within three years after becoming a Party to the Convention. This paper aims to assess the progress made in the implementation of Article 11 in countries of the Eastern Mediterranean Region (EMR) and Western Pacific Region (WPR) in relation to the entry into force of the WHO FCTC, highlighting regional differences.
Methods:
We assessed the tobacco control laws and regulations up to December 2014 from all 49 countries in both regions against 15 time-bound measures of Article 11.
Results:
Most countries (44, 90%) adopted text-based health warnings. After they were formally bound by the Convention, 25 countries (51%) introduced pictorial health warnings (PHWs); 13 (59%) in the EMR and 12 (44%) in the WPR. However, only 11 countries (44%) met the deadline. Overall, just 10 countries (20%) were highly compliant with the time-bound measures, yet none was fully compliant with all 15 measures. The most common adopted time-bound measure was mandating health warnings in the national tobacco control laws (90%), while the least common was banning descriptors depicting flavours (4%).
Conclusions:
Ratifying the WHO FCTC created a breakthrough in implementing some time-bound measures of Article 11 and strengthening health warnings, specifically facilitating the introduction of PHWs in both regions. Continued efforts to fully implement the time-bound measures of Article 11 are still needed in both regions.
Article 11 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) forms the basis for regulation of tobacco product packaging and labelling. Countries are required to implement these measures within three years after becoming a Party to the Convention. This paper aims to assess the progress made in the implementation of Article 11 in countries of the Eastern Mediterranean Region (EMR) and Western Pacific Region (WPR) in relation to the entry into force of the WHO FCTC, highlighting regional differences.
Methods:
We assessed the tobacco control laws and regulations up to December 2014 from all 49 countries in both regions against 15 time-bound measures of Article 11.
Results:
Most countries (44, 90%) adopted text-based health warnings. After they were formally bound by the Convention, 25 countries (51%) introduced pictorial health warnings (PHWs); 13 (59%) in the EMR and 12 (44%) in the WPR. However, only 11 countries (44%) met the deadline. Overall, just 10 countries (20%) were highly compliant with the time-bound measures, yet none was fully compliant with all 15 measures. The most common adopted time-bound measure was mandating health warnings in the national tobacco control laws (90%), while the least common was banning descriptors depicting flavours (4%).
Conclusions:
Ratifying the WHO FCTC created a breakthrough in implementing some time-bound measures of Article 11 and strengthening health warnings, specifically facilitating the introduction of PHWs in both regions. Continued efforts to fully implement the time-bound measures of Article 11 are still needed in both regions.
REFERENCES (52)
1.
Hammond D: Tobacco labelling & packaging toolkit: A guide to FCTC Article 11. Chapter 1 Evidence review 2009, 9-46. Available from: http://www.tobaccolabels.ca/wp... (accessed June 2016).
2.
Villanti AC, Cantrell J, Pearson JL, Vallone DM, Rath JM: Perceptions and perceived impact of graphic cigarette health warning labels on smoking behavior among U.S. young adults. Nicotine Tob Res 2014, 16(4):469-477. doi: 10.1093/ntr/ntt176.
3.
Azagba S, Sharaf MF: The effect of graphic cigarette warning labels on smoking behavior: evidence from the Canadian experience. Nicotine Tob Res 2013, 15:708-717. doi: 10.1093/ntr/nts194.
4.
Vardavas CI, Connolly G, Karamanolis K, Kafatos A: Adolescents perceived effectiveness of the proposed European graphic tobacco warning labels. Eur J Pub Health 2009, 19(2):212-217. doi: 10.1093/eurpub/ckp015.
5.
O’Hegarty M, Pederson LL, Nelson DE, Mowery P, Gable JM, Wortley P: Reactions of young adult smokers to warning labels on cigarette packages. Am J Prev Med 2006, 30:467-473. doi: 10.1016/j.amepre.2006.01.018.
6.
White V, Webster B, Wakefield M: Do graphic health warning labels have an impact on adolescents’ smoking-related beliefs and behaviours? Addiction 2008, 103(9):1562-1571. doi: 10.1111/j.1360-0443.2008.02294.x.
7.
Borland R, Hill D: Initial impact of the new Australian tobacco health warnings on knowledge and beliefs. Tob Control 1997, 6:317-325. PMID: 9583630.
8.
Hammond D, Fong GT, Borland R, Cummings KM, McNeill A, Driezen P: Text and graphic warnings on cigarette packages: findings from the international tobacco control four country study. Am J Prev Med 2007, 32:202-209. doi: 10.1016/j.amepre.2006.11.011.
9.
Hammond D, Fong GT, McNeill A, Borland R, Cummings K M: Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Control Four Country Study. Tob Control 2006, 15(III):19-25. doi: 10.1136/tc.2005.012294.
10.
Cunningham R: Cigarette package warning size and use of pictures: international summary. Canadian Cancer Society 2011:1-3. Available from:.http://www.tobaccolabels.ca/wp... (accessed January 2015).
11.
Institute for Global Tobacco Control. State of Evidence Review: Health Warning Labels on tobacco products 2013. Available from: http://www.globaltobaccocontro... (accessed December 2014).
12.
Centers for Disease Control and Prevention. Cigarette Package Health Warnings and Interest in Quitting Smoking -14 Countries, 2008–2010. MMWR Morb Mortal Wkly Rep 2011, 60(20):645-651. Available from: http://www.cdc.gov/mmwr/pdf/wk... (accessed January 2015).
13.
European Commission. Eurobarometer: Survey on tobacco (analytical report) 2009. Available from: http://ec.europa.eu/public_opi... (accessed June 2016).
14.
Centers for Disease Control and Prevention. Health Warnings on Tobacco Products - Worldwide, 2007. MMWR Morb Mortal Wkly Rep 2009, 58(19):528-529. Available from: http://www.cdc.gov/mmwr/PDF/wk... (accessed January 2015).
15.
Shanahan P, Elliott D: Evaluation of the effectiveness of the graphic health warnings of tobacco product packaging 2008. Australian Government Department of Health and Ageing, Canberra 2009. Available from: http://www.smoke-free.ca/warni... (accessed June 2016).
16.
World Health Organization. WHO report on the global tobacco epidemic, 2011. Warning about the dangers of tobacco. Available from: http://www.who.int/tobacco/glo... (accessed December 2014).
17.
World Health Organization. WHO Framework Convention on Tobacco Control 2003. Available from: http://www.who.int/tobacco/fra... (accessed February 2014).
18.
World Health Organization. Guidelines for implementation of Article 11 of the WHO Framework Convention on Tobacco Control (packaging and labelling of tobacco products) 2008. Available from: http://www.who.int/fctc/guidel... (accessed February 2014).
19.
World Health Organization. Framework Convention on Tobacco Control. Elaboration of guidelines for implementation of Article 11 of the Convention 2008. Available from: http://apps.who.int/gb/fctc/PD... (accessed February 2014).
20.
World Health Organization. Tobacco Free Initiative. Global Adult Tobacco Survey 2015. Available from: http://www.who.int/tobacco/sur... (accessed January 2015).
21.
World Bank. Data. Country and Lending Groups. Available from: http://data.worldbank.org/abou... (accessed June 2016).
22.
World Bank. Data. New Country Classifications. Available from: http://data.worldbank.org/news... (accessed June 2016).
23.
World Health Organization. WHO report on the global tobacco epidemic, 2015. Raising Taxes on Tobacco. Available from: http://apps.who.int/iris/bitst... (accessed October 2016).
24.
World Health Organization. Parties to the WHO Framework Convention on Tobacco Control. Available from: http://www.who.int/fctc/signat... (accessed June 2016).
25.
United Nations. Treaty Collection. Chapter IX Health. 4. WHO Framework Convention on Tobacco Control. Available from: https://treaties.un.org/pages/... (accessed June 2016).
26.
World Health Organization. 2014 global progress report on implementation of the WHO Framework Convention on Tobacco Control. Available from: http://www.who.int/fctc/report... (accessed June 2016).
27.
Awopegba AJ, Cohen JE: Country tobacco laws and article 11 of the WHO Framework Convention on Tobacco Control: a review of tobacco packaging and labeling regulations of 25 countries. Tob Induc Dis 2013, 11:23. doi: 10.1186/1617-9625-11-23.
28.
World Health Organization. Regional Office for the Eastern Mediterranean Region. Tobacco Free Initiative. Country Legislation. Available from: http://www.emro.who.int/tobacc... (accessed January 2015).
29.
World Health Organization. WHO Framework Convention on Tobacco Control. Available from: http://apps.who.int/iris/bitst... (accessed October 2016).
30.
U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Printed with corrections, January 2014. Available from: http://www.surgeongeneral.gov/... (accessed June 2016).
31.
Satomura K, Iwanaga S, Noami M, Sakamoto R, Kusaka K, Nakahara T: The Framework Convention on Tobacco Control (FCTC) and Japanese anti-tobacco measures. Tob Induc Dis 2008, 31, 4:3.doi: 10.1186/1617-9625-4-3.
32.
World Health Organization. WHO global health days. World No Tobacco Day. Frequently asked questions: Plain packaging of tobacco products 31 May 2016. Available from: http://www.who.int/campaigns/n.... (accessed October 2016).
33.
Levy DT, Ellis JA, Mays D, Huang AT: Smoking-related deaths averted due to three years of policy progress. Bull World Health Organ 2013, 91:509-518. doi: 10.2471/BLT.12.113878.
34.
Post-Implementation Review Tobacco Plain Packaging 2016. Australian Government. Department of Health. Available from: https://ris.govspace.gov.au/fi... (accessed June 2016).
35.
Roskin J, Avevard P: Canadian and English students’ beliefs about waterpipe smoking: a qualitative study. BMC Public Health 2009, 10:9-10. doi: 10.1186/1471-2458-9-10.
36.
The Tobacco Atlas. Smokelss Tobacco. Available from: http://www.tobaccoatlas.org/to... (accessed June 2016).
37.
Conner RJ: Non-cigarette tobacco products: what have we learnt and where are we headed? Tob Control 2012, 21:181-190. Available from: http://tobaccocontrol.bmj.com/... (accessed June 2016). doi: 10.1136/tobaccocontrol-2011-050281.
38.
Nakkash R, Khalil J: Health warning labelling practices on narghile (shisha, hookah) waterpipe tobacco products and related accessories. Tob Control 2010, 19:235-239. doi: 10.1136/tc.2009.031773.
39.
Centers for Disease Control and Prevention. Global Tobacco Surveillance System Data. Available from: http://nccd.cdc.gov/gtssdata/A... (accessed June 2016).
40.
World Health Organization. Tobacco Free Initiative. Global Youth Tobacco Survey 2015. Available from: http://www.who.int/tobacco/sur... (accessed January 2015).
41.
World Health Organization. WHO report on the global tobacco epidemic, 2015. Raising taxes on tobacco. Available from: http://www.who.int/tobacco/glo... (accessed June 2016).
42.
World Health Organization. WHO Framework Convention on Tobacco Control Implementation Database. Available from: http://apps.who.int/fctc/imple... (accessed June 2016).
43.
Vupputuri S, Hajat C, Al-Houqani M, Osman O, Sreedharan J, Ali R, Crookes AE, Zhou S, Sherman SE, Weitzman M; United Arab Emirates Tobacco Control Research Collaborative: Midwakh/dokha tobacco use in the Middle East: much to learn. Tob Control 2016, 25:236-241. doi: 10.1136/tobaccocontrol-2013-051530.
44.
Maziak W, Ben Taleb Z, Bahelah R, Islam F, Jaber R, Auf R, Salloum RG: The global epidemiology of waterpipe smoking. Tob Control 2015, 24:i3-i12. doi: 10.1136/tobaccocontrol-2014-051903.
45.
Singh A, Owusu-Dabo E, Britton J: “Pictures don’t lie, seeing is believing”: exploring attitudes to the introduction of pictorial warnings on cigarette packs in Ghana. Nicotine Tob Res 2014, 16(12):1613-1619. doi: 10.1093/ntr/ntu127.
46.
Maynard OM, Munafò MR, Leonards U: Visual attention to health warnings on plain tobacco packaging in adolescent smokers and non-smokers. Addiction 2013, 108(2):413-419. doi: 10.1111/j.1360-0443.2012.04028.x.
47.
Maynard OM, Leonards U, Attwood AS, Bauld L, Hogarth L, Munafò MR: Plain packaging of cigarettes and smoking behavior: study protocol for a randomized controlled study. Trials 2014, 15:252. doi: 10.1186/1745-6215-15-252.
48.
Hogarth L, Maynard OM, Munafò MR: Plain cigarette packs do not exert Pavlovian to instrumental transfer of control over tobacco-seeking. Addiction 2015, 110(1):174-182. doi: 10.1111/add.12756.
49.
Maynard OM, Leonards U, Attwood AS, Bauld L, Hogarth L, Munafò MR: Effects of first exposure to plain cigarette packaging on smoking behaviour and attitudes: a randomised controlled study. BMC Public Health 2015, 15:240. doi: 10.1186/s12889-015-1586-8.
50.
Wakefield MA, Hayes L, Durkin S, Borland R: Introduction effects of the Australian plain packaging policy on adult smokers: a cross-sectional study. BMJ Open 2013, 3(7) pii: e003175. doi: 10.1136/bmjopen-2013-003175.
51.
Durkin S, Brennan E, Coomber K, Zacher M, Scollo M, Wakefield M. Short-term changes in quitting-related cognitions and behaviours after the implementation of plain packaging with larger health warnings: findings from a national cohort study with Australian adult smokers. Tob Control 2015, 24:ii26-ii32. doi: 10.1136/tobaccocontrol-2014-052058.
52.
Japan Tobacco Inc. - Company Profile, Information, Business Description, History, Background Information on Japan Tobacco Inc. Available from: http://www.referenceforbusines... (accessed June 2016).
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