Background and challenges to implementation:
Tobacco use is a major factor of many diseases such as lung diseases, cancers and cardiovascular diseases which are results in death in the world. Currently around 7.2 million of users and 900,000 nonusers die each year due to tobacco use and exposure to secondhand smoke
In Cambodia, smoking prevalence among adult men remains high. About 1.6 million of adults currently smoke tobacco products. In 2016, 1.5% of youth currently use any tobacco product while 0.6% currently smoke cigarettes.

Intervention or response:
The sub-decree on 55% of Pictorial Health Warning on package of tobacco products in Cambodia was approved on 22nd October 2015 and it is to become effective from 22nd July 2016. The study aims to identify effectiveness of PHW on behavior changes of current smokers with specific focus as follow: - Identify exposure, perceptions, attitudes of current smokers to PHW - Examine the effect of PHW on behavioral changes of current smokers (consider quitting smoking & quit)

Results and lessons learnt:
Finding shows no participants have seen PHW on cigarette packs available in the market. More than 90% of the respondents exposed text health warning on cigarette pack. Most of the respondents believed that health warning on cigarette packs are effective at communicate the health effects of smoking to public, in motivating smokers/tobacco users to quit, prevent youth not to start smoking/using tobacco products, and ex -tobacco users to stay on quit. Nearly 90% of respondents supported government initiative to implement PHW on packs of tobacco products.

Conclusions and key recommendations:
Enforcement of the fully implementation of the sub-decree on 55% pictorial health warning is essential. Tobacco industry is key player to ensure the compliance to the sub-decree, and this needs strong commitment from all tobacco stakeholders at national and sub-national levels actively participate to motivate tobacco industry, wholesalers, and retailers to effectively implement the sub-decree on 55% PHW.