Background and challenges to implementation:
Graphic health warnings effectively communicates health hazards of tobacco use - consumers see warnings thousands of times. Evidence shows that large graphic health warnings on tobacco packs are efficient and cost-effective. As per law (COTPA 2003, Section 7), it is mandatory to implement pack warnings across all tobacco products in India. Since April 1, 2016, India requires 85 percent graphic health warnings to be printed on both sides of all tobacco product packets.

Intervention or response:
Two months after implementation of rules, a study was undertaken by VHAI and seven partners to monitor the compliance of 85 percent graphic warning labels (GWLs) in 8 states on three types of tobacco product packaging. This included - Cigarettes, Bidis and Smokeless.
The tobacco packets were collected in 2 commercial areas (Low and High Income Zones) from kiosks, tobacco specialists, street vendors, independent small groceries, supermarkets, and other venues selling tobacco.
The sample included 786 cigarette packs (24 brands, 4 tobacco companies), 665 packs of smokeless tobacco (7 types of products, 48 brands, 36 tobacco companies, 20 brands of non-identified tobacco companies), 539 bidi packs (23 bidi companies and 50 brands of non-identified bidi companies.

Results and lessons learnt:
67% cigarette brands, 16% bidi brands and 46% smokeless brands were fully complying with the new 85 percent graphic health warnings.

Conclusions and key recommendations:
The Government must strictly enforce the HWL's rules as health warnings on tobacco packages are a direct, cost-effective means of communication to inform the health risks of tobacco consumption to the consumers/new users/illiterate population.