Many countries do not require that health warnings be placed at the top of the principal display area. In addition, many country laws do not require health warnings to be located where they would not be obstructed by required markings on packs, or damaged/concealed with the opening and closing of packs. Most countries in INK 128 solubility the selection

(except Mexico, Spain, Turkey, Nepal and Australia) do not meet all the requirements for location of health warning labels as required by the FCTC. Though large warnings have been shown to be effective by both smokers and non-smokers [18,19], placing them at the top of the PDA can further enhance their effectiveness and noticeability. Most country laws in the selection did not prohibit

the use of all forms of misleading descriptors on packs, except Australia and Mexico, which comply with all the requirements of the FCTC with respect to this category. Countries’ laws were especially weak in prohibiting the display of quantitative emission yields on their packs. Users of these products may still ascribe lower risks to brands that have lower levels of tar, carbon monoxide or nicotine, attenuating the effect that the prohibition of the use of misleading terms such as “mild” “light”, may have had. Six countries in the selection (South Africa, Kenya, Poland, Indonesia, Philippines and China) are yet to mandate the use of health warnings that contain pictograms. It is also important to note that most of these are low-and middle-income countries, where health literacy may be relatively low.

Though the use of pictograms is not a requirement, countries can strengthen the impact of their warning labels by using graphic color images. Strong warnings that utilize graphic pictograms, and not just text, are shown to be more effective in getting the attention of users, conveying the significance of the text warning and ultimately inducing a change in the perception of risk by the users [18,20-27]. Studies have shown that smokers tend to notice health warnings with pictures more than they do warnings without [21,28]. Pictograms would convey a stronger message, especially in low-literacy settings, or in cases where text warnings are very weak in conveying the harms of tobacco use. Strong health warning messages can influence the decision to initiate or quit smoking GSK-3 [5,6], and these measures can be implemented at no cost to governments [7]. Some countries like Canada [19,29,30], Australia [11], Brazil [31], Singapore [32] and Thailand [33] have seen significant change in perceptions and attitudes toward smoking following implementation of some of these FCTC-recommended best-practices in health warning display. Barriers to implementing best practices in tobacco packaging and labeling, as stipulated by the FCTC, would vary by country. Countries should share their successes and challenges, and collaborate on possible strategies to strengthen their tobacco laws.