Fight for 85% pictorial health warnings on tobacco product packages - a success story from India
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Government of India, Ministry of Health and Family Welfare, India
International Union Against Tuberculosis and Lung Disease, Tobacco Control, India
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A747
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Background and challenges to implementation:
The pictorial health warning (PW) is the most cost effective measure to create awareness about adverse health consequences of tobacco usage. Section 5 of Indian Tobacco Control Act (COTPA-2003) requires printing of specified pictorial health warning on all tobacco product packages.
Though PW were first notified in 2006, its implementation was deferred time and again due to the challenge posed by Tobacco Industry (TI). First ever PW (40% on one side of pack only) was printed from May 2009 on direction of the Supreme Court. But its insufficient size and placement it had failed to have the deterrent effect on tobacco users. Thereafter, on recommendation of the Expert Committee, the Government revised PWs and notified the new set of field tested PWs covering 85% display area on October 2014.
But as expected, its implementation was delayed by multiple court cases by TI and representations and appeals from their front groups. An Indian parliamentary committee and a High Court also issued adverse orders.

Intervention or response:
Indian Government took firm stand against these challenges and defended the new PWs before Supreme Courts as well as several High Courts. It was also unflinchingly responded to the committees' queries in support of the PWs with scientific evidences and legal provisions. Indian civil societies coordinated efforts and intense media advocacy provided further strength to the Governments' stand.

Results and lessons learnt:
The interventions and response from the Government and Civil Society resulted in the High Courts and the Supreme Court of India passing orders supporting the enforcement of the new warnings from 1st April 2016.

Conclusions and key recommendations:
The case discussed confirms that with strategically planned approach, robust scientific evidence, legal provisions, judicial precedents, will collaborated efforts of all tobacco control stakeholders, it is possible to counter any TI interference to deflect the Government's initiatives.