Background and challenges to implementation:
TII has been a major roadblock in implementing policies particularly since some policymakers have represented farmers constituencies and lobbies, and have direct and indirect links with tobacco companies as well. For the past ten years, India has observed many instances, including dilution and delaying of pictorial health warnings (PHWs) of TII. TII was seen openly during FCTC COP-7 held in New Delhi, India in November 2016, where the tobacco industry used farmers and front groups, and demanded that it be allow to participate in COP 7 and labelled their exclusion as "undemocratic". There is a felt need for a national law that complies with Article 5.3 of FCTC. Given that health is a state subject the efforts to advance Article 5.3 policy has to take place at the state and national level.

Intervention or response:
This case study examines the evidence of TII at the state-level and presents it to policymakers for a development of a guideline for its prohibition in line with FCTC Article 5.3.

Results and lessons learnt:
In 2015-2016 the states of Punjab and Mizoram, followed by Bihar and Himachal Pradesh have developed (in 2017) state policies which encompass constitution of an empowered committee and protocol to deal with tobacco industry. In 2017 three districts of Karnataka and two districts of West Bengal (Darjeeling and Howrah) have passed similar notifications. Few other states including Rajasthan, Kerala, Sikkim and Jharkhand have agreed in principal to enact such sub-national laws that will strengthen the argument to develop a national policy.

Conclusions and key recommendations:
The advocacy efforts of civil societies through state-level coalitions and partnerships, judicial direction and media led advocacy are creating awareness for states to adopt sub-national policy to stop TII. This will gradually build generate evidences and build precedence for Government of India to develop and adopt a national policy.