Countries in each WHO region were ranked, from highest to lowest, by estimated number of smokers. The first six countries in the European Region, molecule library as well as the first five countries in each of other WHO regions were selected to give a sample with the highest contribution to the global burden of smoking across all WHO regions. In instances where country laws were not available, or where verified translations were not accessible electronically, the next country on the list was selected, provided the numbers of smokers in both countries were comparable. In the African and

Eastern Mediterranean regions, where these numbers were far apart, fewer countries were selected. This led to a final selection of 25 countries: six countries in the European region, five countries in the Americas, South-East Asia and Western Pacific regions, and two countries in the African and Eastern Mediterranean regions. The countries by region are as follows: Africa (South Africa, Kenya); The Americas (Mexico, Canada, Brazil, Argentina, USA); South-East Asia (Nepal, Thailand, India, Bangladesh, Indonesia); Europe (Spain, Turkey, Poland, United Kingdom, Ukraine, Russia); Eastern

Mediterranean (Pakistan, Egypt) and Western Pacific (Australia, Malaysia, Philippines, Vietnam, China). Scoring criteria We examined the FCTC article guidelines and distinguished required guidelines from optional recommendations by careful examination of how they were worded.

Required guidelines were considered those that used words such as “must”, “should”, or “shall”; while optional guidelines were classified as those that used words such as “may” or “can”, or contained phrases like “Parties should consider…”. The resulting scoring criteria contained 19 mandatory health warning components grouped under the following five categories: location, size, message content, language and display of misleading descriptors. We also assessed optional recommendations such as the use of pictograms, contrast, and the provision of a “quit line” number. We used the scoring criteria thus created to assess each country’s compliance with FCTC article 11 guidelines on tobacco packaging and labeling. We extracted country tobacco laws from the Campaign for Tobacco-Free Kids website http://www.tobaccocontrollaws.org[14], Batimastat as this was considered a reliable source of verified translations of the tobacco packaging and labeling laws of different countries. We awarded one point for meeting each required guideline and one-half point where guidelines partially complied with the FCTC requirements. If a country’s laws did not precisely reflect what the FCTC guidelines specify, no point was awarded. Thus, higher total scores indicate greater alignment of the laws with the guidelines. Analysis Scores across all article 11 requirements were totaled for each country to reflect the overall level of alignment with the guidelines.