BACKGROUND: At least 138 countries have mandated pictorial health warnings (PHWs), and 26 have adopted standardised packaging (SP) in compliance with Article 11 of the WHO Framework Convention on Tobacco Control (FCTC). The Southeast Asia Tobacco Control Alliance developed the Article 11 Index based on the FCTC Article 11 implementation guidelines adopted by the Conference of Parties to measure progress, identify gaps and challenges, and allow regional comparisons in complying with these measures.
METHODS: A self-administered questionnaire was developed based on FCTC Article 11 guidelines and completed by focal points in the ten ASEAN countries according to existing laws and regulations.
RESULTS: All ASEAN countries have implemented PHWs and allow copyright-free sharing of PHW images regionally; however, some countries have yet to apply these warnings to all types of tobacco products, and PHW rotation has been delayed in Indonesia, Malaysia, and Vietnam. Tax stamps partially obscure PHWs in most countries, despite regulations prohibiting this. Thailand has the largest PHWs (85% size), followed by Brunei, Lao PDR, Myanmar and Singapore (75% size). Except for the Philippines, all countries require PHWs on the upper principal areas of packaging.
Thailand was the first in Asia to require SP (2019), followed by Singapore (2020), Myanmar (2022), and Lao PDR (2024), but the industry continues to delay the full implementation of SP in Myanmar and Lao PDR. Misleading descriptors are banned in all ASEAN countries, except Brunei. Emission yield figures are prohibited in Brunei, Myanmar, Philippines, and Thailand, but Vietnam allows printing of an expiry date on packages. SP and PHWs are mandated for tobacco products sold in duty-free outlets.
CONCLUSIONS: The Article 11 Index is a useful tool for assessing compliance with FCTC Article 11 and its guidelines and for advocating for stronger national policies and their implementation.