Abstract
Objectives: Compare the brand availability, pricing and presence of illicit products in semi-urban and rural areas in India across product types and states. Methods: In late 2017, 382 unique tobacco products were purchased from localities with populations under 50,000 in the states of Assam, Karnataka, Maharashtra, Rajasthan, and Uttar Pradesh. Brand, printed maximum retail price, price paid, tax, and health warning labels (HWLs) were used to compare the market for bidis, smokeless tobacco (SLT), and cigarettes. Results: Brand availability and pricing of SLT products was similar to cigarettes. Brand availability and pricing of bidis was consistent with having many small producers. Bidis and single serving SLT with spice mixtures were more affordable than cigarettes and SLT sold alone. 2% of SLT and 10% of cigarettes did not feature an India HWL. Conclusion: The elimination of single serving SLT packets and the removal of tax exemptions for small producers, often exploited by bidi producers, could reduce their respective affordability. State differences in illegal and illicit products could indicate a greater need for enforcement in some states.
Highlights
India is the second leading consumer, third largest producer and fifth largest exporter of tobacco products globally [1]
This study focuses on brand availability, tax avoidance, prices relative to the maximum retail price (MRP), and the presence of illegal/illicit tobacco products
Because a majority (68.8%) of the Indian population resides outside urban areas [19] and the consumption of bidis and smokeless tobacco (SLT) is predominantly in these settings, this study aimed to examine semi-urban and rural areas
Summary
India is the second leading consumer, third largest producer and fifth largest exporter of tobacco products globally [1]. According to the 2016–17 Global Adult Tobacco Survey (GATS), 28.6% (266.8 million) of the adult Indian population currently use some type of tobacco. What differentiates India from other countries is that smokeless tobacco (SLT) use exceeds smoked tobacco use; 21.4% (199.4 million) of adults use SLT and 10.7% (99.5 million) use a smoked form. The number of current cigarette smokers (37.5 million) is surpassed by the number of current bidi (a cheap, unfiltered cigarette made of tobacco flakes wrapped in a tendu or temburni leaf) smokers (71.8 million) [2]. Bidis and SLT are popular outside of urban areas and among people with lower incomes and education [3,4,5,6,7].
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