Background and challenges to implementation:
Smokeless tobacco (SLT) use is highly prevalent in Myanmar, particularly among women and youth. Ministry of Health and Sports has established and strengthened smokeless tobacco control programme at national and subnational level by adopting comprehensive policy of tobacco control since 2012, with the support of WHO and The UNION.

Intervention or response:
These key policies are inclusion of SLT as an integral part of the national and local tobacco control frameworks, Raising public awareness on the adverse health and social consequences of SLT use, banning smokeless tobacco in public places, workplaces and public transport , Strengthening SLT Free Youth Programme, Inclusion of SLT use into regular Global Tobacco surveillance mechanisms and preventing tobacco industry interference on SLT.

Results and lessons learnt:
Key policy achievements were made i)adopted a smoke free national regulation which bans smoking in all public places, work places and public transport; ii)adopted a pictorial health warning regulation that mandates tobacco industry to print at least 75% pictorial health warning on all tobacco pack including smokeless tobacco both in front and back on upper part. In addition we have built capacity of national and sub-national tobacco control cell and officials from health, NGOs and media.
Tobacco control Policy awareness was built among member of parliaments and inter-ministerial departments. According to 2016 Global Youth Tobacco Survey (GYTS), current smokeless tobacco use among students aged 13-15 years had declined from 9.8% to 5.7% between 2011 and 2016.

Conclusions and key recommendations:
Misconception of SLT use as less dangerous than smoking products is a big challenge to the tobacco control measures added by ease of purchase and low prices of SLT products. Efforts should be prioritized on law enforcement as well as amendment of existing national law to include the control of SLT products and illicit trade of tobacco in Myanmar.