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Table 1 Israel Legislation Progress in the Context of the World Health Organization’s FCTC and MPOWER measures

From: Historic tobacco legislation in Israel: a moment to celebrate

Prior to the 7th Amendment to the law on Restrictions on Advertising and Marketing of Tobacco Products

Following the Dec. 31, 2018 passage of the Ban on Advertising and Restrictions on Marketing of Tobacco and Smoking Products

Framework Convention of Tobacco Control Articles

MPOWER Scorea

Addressed only tobacco products (combustible, smokeless and heated)

Includes both tobacco products (combustible, smokeless, and heated) and any smoking and/or vaping products

NA

NA

Specified restrictions on advertisement

Complete ban on advertisement

Article 13.4.e:

MPOWERa - Enforce bans on advertising, promotion and sponsorship

Except:

Undertake a comprehensive ban or, in the case of a Party that is not in a position to undertake a comprehensive ban due to its constitution or constitutional principles, restrict tobacco advertising, promotion and sponsorship on radio, television, print media and, as appropriate, other media, such as the internet …

1. Newspapersb

2. Specialised tobacco and/or alcohol shops

The new legislation did not improve MPOWER score compared to the previous legislation:

3. Art objects

4. Direct written mailing to over 21 years old, with pre-authorization

Score 3: Ban on national TV, radio and print media as well as some (but not all) other forms of direct and/or indirect advertising

Ban on using human or animal figures, including cartoons, to market tobacco products

Expanding the ban to include also the use of fruit or any kind of plant figure (refers to allowed ads only and packaging)

Article 13.4.a:

Prohibit all forms of tobacco advertising, promotion and sponsorship that promote a tobacco product by any means that are false, misleading or deceptive or likely to create an erroneous impression about its characteristics, health effects, hazards or emissions;

General unspecified restriction on using indirect advertisement for tobacco products

1.Specifies that no use can be made of tobacco/smoking products brand name/nickname/symbols and/or resemblance of these to promote other products

Article 16.1.c:

Prohibiting the manufacture and sale of sweets, snacks, toys or any other objects in the form of tobacco products which appeal to minors

2. Ban on sales of any candy or toys that resemble cigarettes

Warning area on package 30% for tobacco products, includes rotating print warnings

1. For tobacco products – warning area increased to 65% of package, continues to include rotating print warnings

Article 11:

MPOWER - Warning labels on tobacco packaging

Packaging and labelling of tobacco products

Article 13.4.b:

2. For vaping products – warning area 30%, warning, will read “this product is highly addictive and harmful to your health”

Require that health or other appropriate warnings or messages accompany all tobacco advertising and, as appropriate, promotion and sponsorship

The new legislation improved the MPOWER score from 3 to 4

3. For smoking products (without tobacco, such as herbal) - warning area 30%, warning, will read “smoking causes morbidity and premature death”

Score 4: Medium size warnings with all appropriate characteristics OR Large warnings missing some appropriate characteristics

Does not include any restrictions on point-of-sale placement

All products will not be visible to the consumers

Article 16.1.b:

NA - Additional measures not included in the MPOWER

Except:

Banning the sale of tobacco products in any manner by which they are directly accessible, such as store shelves

1. Specialised tobacco and/or alcohol shops (as long as not visible from outside the store)

2. Duty-free shops (as long as will not be visible from the outside or from other parts of the shop)

3. Dedicated online shops (allowed to only include specific details of the product without pictures)

Did not include any regulation on contents of products

Restricts the nicotine content in vaping products to 20 mg/ml maximum

Article 9

Regulation of the contents of tobacco products

Did not include any reference to vaping products

Vaping products must be sold in child-proof packaging

NA

Restricting sales to underage minors (< 18 years old) of tobacco products

Extending this restriction to include also all vaping products and any herbal smoking products

Article 16.1:

Each Party shall adopt and implement effective legislative … .to prohibit the sales of tobacco products to persons under the age …

Did not include plain packaging

All tobacco/smoking/vaping products will use plain packaging utilizing the colour Pantone 448 C (except cigars and pipe tobacco)

Article 11:

Packaging and labelling of tobacco products

Did not include package inserts

All tobacco/smoking/vaping products will include a package insert with information on the harms of using these products and referral pathways to cessation support

Article 13.4.b:

Require that health or other appropriate warnings or messages accompany all tobacco advertising and, as appropriate, promotion and sponsorship

Did not include details regarding product content, emission or toxicological data

Requires all manufacturers/importers to disclose once a year all information regarding the content of their products, levels of emissions, and any toxicological data

Article 10:

Regulation of tobacco product disclosures

  1. *Note change in the name of the bill
  2. aMPOWER score according to the WHO Technical note 1: Evaluation of existing policies and compliance, range from 0 to 4 https://www.who.int/tobacco/global_report/en/
  3. bNewspapers were exempt from the complete advertisement ban, but the legislation does include a few expansions to previous restrictions: 1) For each ad, a counter ad by the MOH will be published in the same newspaper; 2) Only one ad per each printed edition; 3) Warning area extended from 5 to 30% of the ad