Abstract

Objectives: In this paper, we assess compliance of cigarette packaging with policies in 9 countries that ban misleading descriptors, assess the presence of other packaging design elements that are misleading to consumers, and identify policy loopholes. Methods: Cigarette packages were systematically collected in 9 countries between 2015 and 2017 – Bangladesh, Brazil, China, India, Indonesia, Philippines, Russia, Thailand, and Vietnam. The packs were coded for banned misleading descriptors and other misleading packaging design elements. Descriptive analyses were conducted. Results: Overall, compliance with explicitly banned misleading descriptors is high across countries, with the exception of packs from Indonesia, where compliance is mod- erate. However, the use of other misleading packaging elements such as alternative descriptors (soft, smooth, mellow), select color descriptors (blue, gold, silver), and a slim pack shape are still widely used in packaging design across the 9 countries examined. Conclusions: Policies that include loopholes or allow for other misleading packaging design elements could weaken the impact of recommended misleading packaging and labeling regulations as laid out in the WHO Framework Convention on Tobacco Control. Stronger provisions are needed and countries should consider comprehensive plain packaging.

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