Mexico requires graphic health warning labels (HWLs) covering 30% of the front, and text HWLs on 100% of the back and one side of cigarette packs1. The tobacco industry has used inserts and onserts (information attached to packaging) to increase marketing space on packs2. Companies can also include marketing on outer packaging that encloses the primary package that directly contains the cigarettes3. Outer packaging provides additional space for advertising and promotion and can obscure HWLs4. For example, Japan Tobacco International introduced a limited-edition tin pack before the implementation of plain packaging in Ireland, seemingly to reduce policy impact5. Here, we describe marketing appeals on Mexican cigarette outer packaging that potentially undermine packaging policy.


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