Assessing industry compliance with the graphic health warnings law in the Philippines: challenges in multisectoral tobacco governance.

Background: In 2014, the Philippines implemented Republic Act 10643, or the Graphic Health Warnings (GHW) Law, in alignment with the WHO Framework Convention on Tobacco Control Article 11, aimed at warning about the harms of tobacco use. The law mandates that all tobacco products in the Philippines carry GHWs that cover 50% of the principal display areas on their packaging, along with textual health warnings and additional health information. This study aims to assess the compliance of the tobacco industry with the requirements of the GHW Law and to identify the challenges of multisectoral tobacco governance in the Philippines.

Methods: We adapted the Tobacco Pack Surveillance System protocol to collect a sample of unique tobacco products across the country. We coded and assessed packs using both the Codebook from the protocol and the Department of Health's (DOH) GHW Law checklist.

Results: We collected 109 tobacco products, predominantly cigarettes (86.24%) and examined 96 eligible products (88.07%) for compliance. Compliance with the GHW Law was low: 6.19% of packs were fully compliant. 65.63% met the requirement for GHW size, and 78.13% followed DOH-prescribed templates. Additionally, 13 packs were illicit by lacking tax stamps and/or GHWs.

Conclusion: Compliance with the GHW Law in the Philippines is low. Challenges in enforcement include ambiguous roles among agencies, weak monitoring of illicit products and inconsistencies in regulatory guidelines. Strengthening enforcement and clarifying agency responsibilities could improve compliance. Implementing plain packaging and involving local governments in monitoring may simplify and improve compliance.