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Winning with the public, winning in court: advocacy lessons learnt from 85% pictorial health warning campaign in Thailand
  1. Natwipa Sinsuwarn1,
  2. Parichart Sthapitanonda2
  1. 1 Department of Mass Communication Technology, Rajamangala University of Technology Thanyaburi, Thanyaburi, Thailand
  2. 2 Department of Communication Arts, Chulalongkorn University, Bangkok, Thailand
  1. Correspondence to Ms Natwipa Sinsuwarn, Mass Communication Technology, Rajamangala University of Technology Thanyaburi, Thanyaburi 12110, Thailand; natwipa_s{at}

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Health warning label: starting point for tobacco control

The tobacco industry in Thailand was formerly a monopoly operated by the Thailand Tobacco Monopoly (TTM). From 1989 to 1991, Thailand was pressured by the transnational tobacco companies (TTCs) to liberalise the tobacco trade. The TTCs asserted that banning foreign imports was contrary to the Charter of the General Agreement on Tariffs and Trade (GATT) (now the World Trade Organization). The GATT concurred, but ruled that Thailand could maintain its tobacco control policies as long as they were equally applied to domestic and imported products. Therefore, in 1992, the Thai government, through the Ministry of Public Health (MOPH), issued the 1992 Tobacco Products Control Act.1–3 Among other measures, the Act mandated health warning labels on tobacco product packaging. In the first phase, six different warning messages were to cover 25% of the front and back of the tobacco package. In 1997, the area was expanded to 33.3% (see figure 1).

Figure 1

The evolution of PHW on tobacco packs in Thailand. PHW, pictorial health warning.

Pictorial health warnings

Thailand was the first country in the Asia and Pacific region to join the WHO Framework Convention on Tobacco Control (FCTC), in 2003. In 2005, to implement Article 11 of the FCTC, the MOPH issued a policy requiring one of six pictorial health warnings (PHWs) along with text on 50% of both the front and back of tobacco packs. TTM and TTCs unsuccessfully appealed to the MOPH to reverse the policy and Thailand became the fourth country in the world to replace text-only warnings with PHWs and to reduce the advertising space on tobacco packaging. In 2009, PHWs on the tobacco pack were expanded to 55% of the front and back (see figure 1).

85% PHW

In Thailand, there was no long-term plan for tobacco control policy because most politicians and government officials do not consider …

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  • Contributors NS contributed towards the overall content, development, review, writing and editing of this manuscript. PS provided substantial information and assistance while drafting this manuscript. All authors provided their final approval for its publication.

  • Funding This paper was funded by grant number MRG5980125 from The Thailand Research Fund and Office of the Higher Education Commission on the project of media advocacy for advancing public health policy in Thailand.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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