Language and Literacy Level


The message content of text-based warnings must target an appropriate literacy level.58 The US warnings implemented in 1984 until 2011, for example, required a college reading level

Screen Shot 2556-02-13 at 11.39.46 AMand may have been inappropriate for youth and Americans with poor reading abilities.  This is particularly important considering that, in many countries, smokers report lower levels of education than the general public. Picture-based warnings may be particularly important in communicating health information to populations with lower literacy rates. Preliminary evidence suggests that countries with pictorial warnings demonstrate fewer disparities in health knowledge across educational levels.

Current International Best Practice

Health warnings in most countries include text with appropriate reading levels. Health Screen Shot 2556-02-13 at 11.40.06 AMwarnings in countries with multiple languages require special consideration. In Canada,which has two official languages, the same warning appears in French on one side of the package and in English on the other side. Other jurisdictions have included more than one language in the same warning. For example, the Belgian warnings, shown at right, display the text in Dutch, French, and German. Because this requires additional space, the size of the Belgian warnings is larger than the Screen Shot 2556-02-13 at 11.39.57 AMminimum European Union standard. Another option is to create separate warnings in each language and then stipulate that the warnings from each language be randomly printed on different packages. In all cases, the use of pictures accompanying the text will be extremely important, given that pictures are universal across languages


Laws and Regulations

Brunei Tobacco (Labelling) Regulations 2007
Malaysia Control of Tobacco Product Regulations Amendment 2008
Singapore Control of Advertising and Sale of Tobacco (Labelling) Regulation Amendments 2003
Singapore Labelling Regulation Amendment 2006
Thailand Ministry of Public Health Notification No.11
Thailand Ministry of Public Health Notification 2009