Impact of India’s National Tobacco Control Programme on bidi and cigarette consumption: a difference-in-differences analysis

Gaurang P Nazar,Kiara C-M Chang,Swati Srivastava,Christopher Millett,Anup Karan,Neil Pearce

doi:10.1136/tobaccocontrol-2018-054621

Abstract

BackgroundDespite the importance of decreasing tobacco use to achieve mortality reduction targets of the Sustainable Development Goals in low-income and middle-income countries (LMICs), evaluations of tobacco control programmes in these...

Highlights

India is home to 267 million tobacco users,[1] the second largest number of tobacco consumers in the world and the country faces a substantial tobacco- related mortality and morbidity burden.[2 3]
►► Evaluations of tobacco control programmes in low-income and middle-income countries (LMICs) are scarce but essential given the importance of reducing tobacco use to achieve both child and adult mortality reduction targets in the Sustainable Development Goals
►► Our findings indicate that early implementation of the National Tobacco Control Programme (NTCP) may not have produced reductions in tobacco use

Summary

Introduction

India is home to 267 million tobacco users,[1] the second largest number of tobacco consumers in the world and the country faces a substantial tobacco- related mortality and morbidity burden.[2 3]. Robust assessment of tobacco control programmes in low- income and middle-income countries (LMICs) is essential given the importance of reducing tobacco use to achieve both child and adult mortality reduction targets in the Sustainable Development Goals (SDGs).[9 10] This includes regular monitoring of achievement against programme goals and objectives and ensuring that resources are allocated properly and spent effectively.[11] robust monitoring and evaluation in LMICs is often constrained by lack of surveillance data new initiatives are seeking to address this, such as the International Tobacco Control Policy Evaluation Project for India which aims to collect longitudinal survey data on key FCTC policy measures from around 10 600 adult informants in four states.[12] Its wave 1 (2010–2011) findings have highlighted a slow and inconsistent progression of tobacco control policies across states (eg, pictorial health warnings, smoke-free public places) and an urgent need to strengthen them.[13]. This study highlights the importance of strengthening the implementation and enforcement of tobacco control policies in LMICs to achieve national and international child health and premature NCD mortality reduction targets

Objectives

Methods

Results

Discussion

Conclusion