Key Recommendations from the Guidelines for Implementation of WHO FCTC Article 11

The following bulleted recommendations, all of which come from the implementation guidelines for Article 11 of the WHO FCTC, cover some of the main aspects to consider:¹

Location

• The placement of the health warning should be chosen to ensure maximum visibility, such as at the top of the main display areas (usually the front and back panels).
• Normal opening of the package should not permanently damage or hide the health warning; nor should they be obstructed by other packaging requirements, such as tax stamps, nor commercial inserts/onserts, stickers, etc.
• Package inserts can be used to provide additional information on health effects and cessation information.

The guidelines also list potential innovative measures that consider placing health warnings on different locations, such as the cigarette stick or filter and other materials and instruments used for tobacco consumption (e.g., papers, waterpipe smoking device).¹

Size

• Health warnings should cover more than 50% of the main display areas (and no less than 30%), with the goal being to cover as much of the packaging as possible.

Label element

• The background and the text should be in contrasting colours to make reading the text as easy as possible.
• Text should be printed in bold with a font size that is easy to read and with a style and colour that increase visibility and legibility.
• Images should be culturally appropriate and in full colour.

Constituents and emissions

• If there are qualitative statements about tobacco emissions (e.g., smoking exposes you to more than 60 cancer-causing chemicals) then these should be in addition to the health warning, either on the main display area or another display area, such as the side.
• Statements about the product constituents and emissions – such as the amount of tar, nicotine, and carbon monoxide – which might imply that one product is less harmful than another, should not be displayed on packs.

Rotation

• Health warnings should be changed periodically, including changes in layout and design, in order to maintain novelty and impact.
• The number of health warnings and messages appearing at the same time should be specified.
• Different health warnings should appear on an equal number of packages, taking into account brand families and variants, including for each package size and type.

Message content

• Parties should consider including different messages, covering various issues related to tobacco, to ensure impact across diverse social groups. These issues may include health impacts, exposure to second-hand smoke, and the social and economic outcomes of tobacco use, amongst others.
• It is important to use clear, concise, and culturally appropriate language in health warnings, as well as an authoritative rather than judgemental tone.
• Evidence suggests that warnings are considered more believable and relevant when they evoke adverse emotional responses, including fear, and when they are personalized.
• Warnings should include information on cessation services, such as a quitline number and websites.

Language

• Warnings should be in a country’s main language(s).
• For countries with more than one main language, the guidelines recommend displaying all languages on each main display area or using a different language on different display areas. The language can also vary based on regions/jurisdictions within a country.

Source attribution

• When a country requires inclusion of the source of statements in the warning, it should appear at the end of the warning and in smaller font.

Relevant Link

• Guidelines for implementation of Article 11 – WHO FCTC Secretariat