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Worldwide news and comment
  1. Marita Hefler
  1. Menzies School of Health Research, Darwin, Northern Territory, Australia
  1. Correspondence to Marita Hefler; marita.hefler{at}

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CANADA: consultation launched for warnings directly on cigarettes

Draft potential examples of warnings directly on cigarettes included in the consultation document published by the Canadian Department of Health.

All articles written by Marita Hefler unless otherwise attributed. Ideas and items for News Analysis should be sent to:

On 26 October 2018, the Canadian Department of Health launched a public consultation to require health warnings directly on cigarettes as part of a broader consultation on the next round of package health warnings. The consultation period ends on 4 January 2019.

In response to the consultation document, health organisation comments to the media noted that the measure is supported by research and by international guidelines under the Framework Convention on Tobacco Control (FCTC) (article 11), and highlighted a number of benefits of requiring warnings on cigarettes. These included reaching every smoker every day with every cigarette at no cost to government, denormalising cigarettes and making them less attractive and generating discussion. It would provide highly cost-effective messaging on the 27 billion cigarettes sold each year in Canada, providing exposure to messages 7300 times per year for a smoker of a package of 20 cigarettes per day, and prompt smokers to think more when the cigarette must be placed in their mouth each time, including when smokers take outside smoking breaks (when they may only take a single stick rather than a package with warning labels). Importantly, it would also provide direct messaging for youth who experiment by ‘borrowing’ cigarettes from friends.

Further, warnings on cigarettes would help combat contraband by indicating cigarettes intended for the legitimate Canadian market and by providing authorities with a further tool for seizing illegal product. In addition, customs authorities at the border would have a new mechanism to seize unmarked cigarette paper raw materials intended for unlicensed factories that illegally manufacture cigarettes.

Draft Canadian plain packaging regulations would prohibit tobacco company brand names, logos, colours and other markings on cigarettes themselves, although a non-descript alphanumeric indication representing a brand would be permitted. In opposing plain packaging regulations, the tobacco industry has argued that removing brand indications from cigarettes would cause contraband. Though this argument has been dismissed by health organisations as being without merit, requiring a health warning on each cigarette nevertheless responds to industry claims.

Regulatory authority to require a health warning on cigarettes was created by bill S-5, a bill amending national tobacco legislation that received final approval with Royal Assent on 23 May 2018. On 28 February 2018, as part of parliamentary proceedings on the bill, the House of Commons Standing Committee on Health adopted with all-party support the amendment for regulatory authority. On World No Tobacco Day, 31 May 2018, national minister of health Ginette Petitpas Taylor publicly expressed support for warnings on cigarettes.

Canada would establish a world precedent by requiring warnings directly on cigarettes which would undoubtedly be followed by other countries.

Rob Cunningham

Canadian Cancer Society

World: Thailand, Singapore, Mauritius & Turkey join plain pack dominoes

Thailand, Singapore, Mauritius and Turkey are the most recent countries to join the growing list of countries which have legislated tobacco plain packaging. Thailand became the first country in Asia to do, when the National Committee on Tobacco Control approved the legislation. It is one of several measures introduced; others include a ban on corporate social responsibility activities, ban on single-stick sales, a requirement for the tobacco industry to report on marketing activities and strengthened smoke-free public places enforcement. Plain packaging will come into force in the second half of 2019 in Thailand. Singapore also announced plans to introduce legislative amendments in 2019 to require plain packaging from 2020, along with other measures, detailed below.

Also in November, Mauritius passed plain packaging legislation, while Turkey introduced amendments to its health laws which will see plain packaging in force from the second half of 2019. Included in the Turkish amendments are a ban on use or promotion of tobacco products in television programmes, films, music videos and theatre plays and on the internet. Tobacco sales at health and education facilities will also be banned.

Singapore: increase in minimum legal age for tobacco

To achieve Singapore’s goal of reducing smoking prevalence to below 10% by 2020 (currently smoking prevalence in Singapore is 13.3%) and further denormalise the use of tobacco among youths, Singapore will increase the minimum legal age (MLA) for tobacco consumption from 18 years to 21 years over a period of 3 years.

A 2008 report by the WHO stated that persons who do not start smoking before the age of 21 ‘are unlikely to ever begin’ while studies have shown that young persons who start smoking early are likely to continue smoking into adulthood. In Singapore, 95% of smokers had their first puff before the age of 21 years and 83% of smokers became regular smokers before they were 21 years old. Raising the MLA to 21 would therefore reduce access to tobacco for youth in this age range, hence preventing or delaying smoking initiation among adolescents.

To minimise the impact on existing smokers aged 18–20 years, the MLA will be progressively increased over a period of 3 years. With effect from 1 January 2019, the MLA will be raised to 19. It will subsequently be raised to 20 on 1 January 2020 and finally 21 on 1 January 2021.

Any person or persons below the MLA found in possession, use or purchase of tobacco products are liable on conviction to a fine of up to $300. They will also be referred to the Health Promotion Board for smoking cessation intervention.

More information about the new law can be found at

Wei Hiong Ng

Health Sciences Authority of Singapore

WORLD: global momentum for picture health warnings

The cover of Cigarette Package Health Warnings: International Status Report, sixth edition, showing health warning labels from the UK, France, Ireland and Hungary.

Graph extracted from Cigarette Package Health Warnings: International Status Report, sixth edition.

A report launched on 1 October 2018 at the FCTC 8th Conference of the Parties (COP8) found that there are now 118 countries and territories requiring picture health warnings on cigarette packages, representing 58% of the world’s population. The report, Cigarette Package Health Warnings: International Status Report, sixth edition, was published by the Canadian Cancer Society.

The report also ranked 206 countries and territories based on cigarette package warning size. Timor-Leste now has the largest warnings in the world at 92.5% on average of the package front and back. The world leaders after Timor-Leste are: Nepal and Vanuatu (both 90%, front and back of pack), New Zealand (75% front, 100% back), and Hong Kong, SAR China, India and Thailand (all 85% front and back).

That small countries such as Timor-Leste, Nepal and Vanuatu are global leaders demonstrates that picture warnings are viable as an effective measure for countries of all sizes.

There are now 53 countries/territories requiring warnings to cover at least 65% (on average) of the package front and back, 107 requiring a minimum size of at least 50% and 148 requiring a minimum size of at least 30%. While the international trend is very encouraging, there are still many countries that have not yet implemented even the 30% minimum required by the FCTC. This underlines the opportunity for substantially more progress ahead.

In 2001, Canada was the first country to require picture warnings on tobacco packages, and the first country with a 50% size. It is no surprise that so many other countries have followed given that package warnings reach every smoker and other tobacco product consumers every day, with the tobacco industry paying the cost. Research shows that the effectiveness of warnings increases with size. Picture warnings are particularly important for those who cannot read, or have low literacy.

Publication of the report was an opportunity for health organisations at the national level to call for implementation of stronger national measures. In the USA, the Campaign for Tobacco-Free Kids decried the fact that the USA was ranked 160th in the world, tied for last, and called on the Food and Drug Administration to move quickly to require graphic health warnings.

The report also found that global progress on plain packaging is accelerating: 25 countries and territories are moving forward with plain packaging, with 9 having adopted the measure and 16 working on it.

The Canadian Cancer Society report was prepared in collaboration with the Framework Convention Alliance (FCA). The Campaign for Tobacco-Free Kids assisted with translation of the report which is available in Arabic, Chinese, English, French, Portuguese, Russian and Spanish. It can be downloaded from under the tab ‘Related resources’.

Rob Cunningham

Canadian Cancer Society

World: Ferrari and PMI keep the chevron glowing

The Philip Morris International ‘Mission Winnow’ logo (source:

In February 2018, Scuderia Ferrari Formula One (F1) team and PMI announced that they had extended their partnership agreement until 2021, with the intention to promote ‘smoke-free’ messages on the cars and team gear over the coming months. At the 2018 Japanese Grand Prix, Ferrari and PMI unveiled ‘Mission Winnow’ (MW) branding on the F1 cars and official team gear. André Calantzopoulos, chief executive officer (CEO) of PMI stated, The word ‘winnow’ (pronounced: ‘win–oh’) was selected because it perfectly describes the meticulous and disciplined route that PMI is following to achieve its ambitious vision of a smoke-free future. The word—and PMI’s vision—is about focus, transparency, care and single-minded determination.”

A website was launched for the new initiative, including short videos focusing on visionaries, researchers, drivers, engineers, believers and winnowers. A social media presence across several platforms was also developed, and fans have been encouraged to share their winnowing stories to win a trip to the Abu Dhabi Grand Prix. A limited edition Haiku book was created with one of Ferrari’s drivers, Kimi Raikkonen. This book received positive coverage via journalists and Sky Sports F1, and viewers were encouraged to tweet in their own Haikus. Fans were also directed to the MW website to win a copy of the book.

Despite claiming that MW is dedicated to ‘No brands. No products.’, the website’s Frequently Asked Questions section regularly mentions PMI and Ferrari’s long partnership (45 years), tobacco advertising, IQOS, Marlboro and the Marlboro chevron. For example, one of the questions asked …Is this new logo a tribute to the Marlboro rooftop, and yet another effort by PMI for subliminal advertising of cigarettes? with the answer claiming that ‘…It is based on the concept of an arrow moving forward…The design is not intended in any way to reflect our brands or products, and we will not use the Scuderia Ferrari car to promote or advertise our products. In fact, since 2007, we have voluntarily removed all tobacco branding from the cars, drivers’ uniforms and racetrack signage, even in countries where such branding was or is permitted.

Comments from readers across MW-related news stories and posts have often been quite critical of this initiative, with several commenters on a Reddit article titled ‘Is Ferrari Mission Winnow just another clever attempt at subliminal Marlboro advertising?’ suggesting that this initiative is yet another attempt to continue promoting PMI’s leading cigarette brand. Other readers noted that the design, colour and location of the MW branding and logo are very similar to the Marlboro logo and chevron.

Ferrari and PMI’s relationship also runs much deeper: after the death of PMI board member and Ferrari president Sergio Marchionne, ex-PMI CEO Louis Camilleri was appointed as the chief executive of the Ferrari team in July 2018. Maurizio Arrivabene, team principal of Ferrari since the end of 2014, was previously the vice-president of global communication and promotions for Marlboro. Despite tobacco advertising being banned in the sport since the end of 2006, Arrivabene represented the sport’s sponsors on the F1 Commission from 2010. Official broadcast footage and photographs have also shown Arrivabene regularly using IQOS, further promoting the use of tobacco products and the strong links between Ferrari and PMI.

Although the sport’s tobacco advertising ban came into effect at the end of 2006, Ferrari raced with Marlboro branding at three Grands Prix in 2007 and used a barcode-style design in place when Marlboro was not advertised. The team name also remained as Scuderia Ferrari Marlboro. After much criticism, Ferrari removed the barcode for 2011 and dropped ‘Marlboro’ from the official team name; however, the logo still incorporated a red and white half-chevron design with black writing. Ferrari used this logo until the end of 2017.

Despite F1’s owners Liberty Media focusing on fan engagement and providing family-friendly entertainment, it appears that little has been done to prevent this latest initiative from proceeding. It also highlights yet another failing by the sports governing body, the FIA, to completely remove tobacco advertising and sponsorship from international motorsport, including in MotoGP (PMI sponsors Ducati). It emphasises the need for the WHO FCTC signatories to urgently address indirect tobacco advertising and sponsorship to comprehensively eliminate the industry’s long history of using astroturfing groups, front-groups and subliminal advertising to promote its own interests and products.

John Baker

La Trobe University, Australia

World: ILO decision to end tobacco industry-funded projects

On 8 November 2018, The International Labour Organization (ILO) reached a significant decision concerning contracts that had tied the institution to the tobacco industry. At the end of its 334th session in Geneva, Switzerland, the ILO governing body adopted an integrated strategy to address decent work deficits in the tobacco sector. For the time being, it will no longer rely on funding from the tobacco industry, including corporations profiting from tobacco and ancillary groups that receive tobacco industry funds. However, the decision does not explicitly preclude future tobacco funding, and it is unclear how the ILO intends to protect itself from the commercial and other vested interests of the tobacco industry in the future.

For now, the ILO decision is consistent with article 5.3 of the WHO FCTC and the model policy for agencies of the United Nations system on preventing tobacco industry interference.

The ILO has a history of engagement with the tobacco industry and has received funding, worth $15 million, through public–private partnerships, for projects aimed at ending child labour in tobacco-growing communities in Brazil, Malawi, Tanzania, Uganda and Zambia. The ILO’s contract with the Eliminating Child Labor in Tobacco Growing Foundation ended in June 2018, and its contract with Japan Tobacco International was due to expire December 2018. The ILO now has an opportunity to not negotiate for the renewal of any contracts, and not establish new contracts with the tobacco industry or its proxies.

The governing body has directed the ILO director general ‘to continue efforts to mobilize various sustainable sources of funding from the public and private sector with appropriate safeguards’. It remains to be seen how the ILO intends to ensure that it no longer funds its child labour projects with tobacco industry money.

The ILO integrated strategy policy document mentions that a number of options are being considered for alternative sources of funding, and consultations are under way with public partners such as the World Bank. The governing body has also directed the ILO director general to organise a tripartite meeting as a matter of urgency, to further develop and implement the integrated strategy.

According to the Framework Convention Alliance, a civil society organisation with nearly 500 non-government member organisations from over 100 countries, the tripartite meeting presents an opportunity to further protect tobacco workers and completely eliminate any undue tobacco industry influence. An article published on the FCA website ( notes, ‘Rejecting funding from tobacco companies will allow the ILO to maintain its impartiality and enhance its capacity to address the issues that trap workers in systemic poverty.’

In an open letter to the ILO governing body, more than 100 public health and sustainable development organisations indicated that the ILO charitable partnerships with the tobacco industry: ‘have a nominal impact on child labour, primarily because the projects focus on the cycle of poverty of tobacco farmers and neglect to address tobacco industry practices such as the administration of unfair contracts, collusion over leaf prices, and inflation of the costs for farm inputs that perpetuate poverty in the first place’. The letter is published at

Tobacco workers and their families in countries including Malawi, Bangladesh and other countries bear most of the risk in tobacco production but are trapped in cycles of poverty due to unfair contracts with tobacco companies. Tobacco-related illnesses place a massive burden on the economies and healthcare systems of low-income and middle-income countries, where nearly 80% of the world’s more than one billion smokers live.

The objective of the WHO FCTC is to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke. In accordance with article 5.3 of the WHO FCTC, sustained and comprehensive action is needed to counteract the tobacco industry’s attempts to block, delay or weaken tobacco-control policies.

As it stands, the ILO decision is a step in the right direction.

Mafoya Dossoumon

Framework Convention Alliance, Canada


  • Patient consent for publication Not required.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.