Abstract
Tobacco is one of the biggest global health concerns of this century with a significant contribution to the increasing burden of cancers, chronic diseases and associated mortality. Tobacco-related cancers are one of the commonest causes of cancer-related mortality in low- and middle-income countries (LMICs). The tobacco epidemic is constantly on the rise, affecting LMICs in particular due to a lack of awareness in the population, insufficient health infrastructure and weak regulatory interventions. India is home to the world’s largest youth population and a large percentage of them take up tobacco at a very young age, leading to subsequent habit formation. There is limited evidence in published research from India on young people’s perceptions on the use and control of tobacco.This qualitative study has attempted to bridge that knowledge gap; a thematic analysis was used on the qualitative data gathered from young university students who participated in interviews and focus group discussions, which was then compared and contrasted with a critical analysis of India’s national tobacco control measures. It employed a health policy analysis framework to understand how gaps in the national tobacco control initiatives contribute towards tobacco use in young people and what opportunities for policy reform exist.The main results revealed social and behavioural factors, peer dynamics and lack of awareness to be majorly influencing the tobacco debut and use in youth. Some other important findings emerged such as a lack of available support for tobacco cessation, leading to failure in quitting, a lack of understanding about the ill effects of tobacco and an overall lack of belief in the existing tobacco control measures. The qualitative results were further triangulated by the critical analysis of the national tobacco control policies, comparing them with the WHO Framework Convention on Tobacco Control. Juxtaposition of the qualitative research findings with the policy analysis reveals possible gaps in implementation of the tobacco laws. The findings from this study will inform health policymakers, public health professionals, clinicians, the government and other voluntary organisations to strengthen national tobacco control efforts.
Highlights
Tobacco is the single most important preventable cause of death globally [1]
Tobacco use is associated with several types of cancers, which are very common in low- and middle-income countries (LMICs), contributing to 50% of all cancers in men and 20% in women [2, 3]
The awareness of young people on the harmful effects of tobacco such as cancer was reported in similar studies conducted in developing countries such as Canada [50], and the factors that influenced the youth regarding tobacco-related behaviour were comparable to a great extent to our findings from India
Summary
Tobacco is the single most important preventable cause of death globally [1]. In adults, it is the second leading cause of mortality, translating to more than 6 million people dying yearly due to tobacco-related diseases [2]. By 2030, tobacco is estimated to kill around 10 million people a year [2,3,4,5] The epicentre of this tobacco epidemic remains in LMICs, with 70% of the estimated deaths and 80% of the total 1 billion smokers in the world coming from there [4,5,6,7,8]. Scientific studies show that all forms of tobacco use can be lethal [12]
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