Background:
The Nepal Tobacco (Control and Regulatory) Act of 2010 mandates government enforcement of at least 75% pictorial health warning (PHW) on tobacco packaging with a provision of the yearly rotation of the pictures and a required size. The enforcement and implementation of the 75% PHW was established successfully in 2014, which prompted the Ministry of Health and Population of Nepal to increase the size requirement to 90% in October 2014 with an enforcement date of 15^th May 2015. However, enforcement of the 90% pictorial health warning still a challenge across the variety of tobacco products.

Methods:
To build policy pressure and awareness, we applied various methods;
i) One to one interview with senior policy makers;
ii) interaction programs with senior government officials;
iii) market monitoring;
iv) disclosing tobacco industry interference.

Results:
Implementation of the 90% pictorial health has been improved. Commitments of Ministry of Health and Ministry of Industry have been built. The Minister of Industry directed the industry to comply the law and regulation of tobacco control. Almost all media have been engaged in tobacco control with especial focus on implementation of pictorial health warning. More than 50 news articles related to pictorial health warning published in last six months with views of senior government officials and related stakeholders. They included Minister of Health, Minister of Industry, MPs, and senior officials and representatives from civil society and professional organizations. Pro-tobacco news were discouraged in most of the media. Industries meeting with health minister and other senior officials were disclosed.

Conclusions:
The media's efforts significantly contributed in policy development and implementation of tobacco control in Nepal. These efforts need to be sustained.