Legal requirements to sell tobacco products in generic, unbranded packaging continue to spread, according to a report released on Feb. 6 by the Canadian Cancer Society (CCS).

The CCS report, titled Cigarette Package Health Warnings: International Status Report, details global progress on plain packaging, ranks 211 countries and territories on the size of their health warnings on cigarette packages and lists the countries and territories that now require graphic picture warnings.

The report also features the new Canadian requirement for a warning on every individual cigarette. This world precedent-setting measure will start to appear on cigarettes in Canada by April 2024. Australia is in progress to become the second country to adopt the measure.

“There is a strong global trend for countries to implement plain packaging,” says Rob Cunningham, senior policy analyst at the CCS, in a statement. “Australia was the first country to implement plain packaging in 2012, followed by France and the U.K. in 2016, and now more and more countries are implementing the measure. These developments are very encouraging as plain packaging is a key measure to protect youth and to reduce tobacco use.”

There are now 25 countries and territories that have adopted plain packaging, up from nine countries in 2018 and 21 countries in 2021.

The report reveals there are now 138 countries and territories that require picture health warnings on cigarette packages, an increase from 117 in 2018 and 134 in 2021. This represents 66.5 percent of the world’s population. Canada became the first country in the world to require picture health warnings in 2001.

“There is continuing progress for countries to use graphic pictures on cigarette packages to show the lethal health effects of smoking,” says Cunningham. “It is extremely positive for global public health that more than 130 countries and territories have required picture health warnings and have increased warning size and that so many are moving toward plain packaging. The international trend will reduce global tobacco industry sales and will save lives lost to cancer and other tobacco-related diseases.”

The release of the CCS report coincides with the 10th Conference of the Parties to the World Health Organization Framework Convention on Tobacco Control (FCTC), which takes place in Panama this week. The FCTC mandates that all parties require health warnings that cover at least 30 percent of the principal display areas and at least 50 percent of the display areas.