Tobacco Products In India Research Articles

Estimating the weight of consumed tobacco product waste in various Indian states: a novel method to assess the potential burden of tobacco product waste

IntroductionThe direct morbidity and mortality caused by tobacco are well documented, but such products also contribute to a range of environmental pollutants resulting from tobacco product waste. No previous studies...

Physical and chemical characterization of smokeless tobacco products in India

The rapid proliferation of smokeless tobacco (SLT) in India has occurred without adequate information on the possible dangers and toxicity of these products. Tobacco flavors as well as nicotine (both protonated and un-protonated) are responsible for health dangers and addiction. The study aimed to offer information on the physical characteristics of commonly used smokeless tobacco products (including microscopic analysis), along with nicotine content (both total and un-protonated), pH, moisture, and flavors. The Standard Operating Procedures (SOPs) validated by the World Health Organization (WHO) recognized Tobacco Testing Laboratory TobLabNet) were applied for the analysis of various constituents of the SLTs. The microscopic analysis indicated that some of the SLT products like khaini were finely processed and available in filter pouches for users’ convenience and prolonged use leading to prolonged retention and addiction potential. Nicotine absorption and availability (both protonated and un-protonated) are affected by moisture and pH. Essences provide a pleasant aroma and flavor, with an increased risk of misuse and other health problems. Few chewing tobacco and Zarda had the lowest levels of un-protonated nicotine (0.10–0.52% and 0.15–0.21%, respectively), whereas Gul, Gudhaku, and Khaini had the highest levels, ranging from 95.33 to 99.12%. Moisture and pH ranged from 4.54 to 50.19% and 5.25–10.07 respectively. Menthol (630.74–9681.42 µg/g) was the most popular flavour, followed by Eucalyptol (118.16–247.77 µg/g) and camphor (148.67 and 219.317 µg/g). SLT’s health concerns and addiction dangers are exacerbated by the high proportion of bioavailable nicotine coupled with flavors. The findings of this study have important implications for the regulation and use of SLT in countries where use of SLT is prevalent.

Comparative assessment of implementation of Cigarette and Other Tobacco Products Act in three States of India: A pre-post study.

The Cigarette and Other Tobacco Products Act (COTPA) limits the sale of tobacco products, promotion and advertising and packaging of tobacco products in India. Periodic monitoring of the level of compliance with all sections of COTPA is obligatory to assess the effectiveness of the act. This pre-post study aimed to assess the change in the level of compliance with different sections of COTPA in selected States. A total of 3849 and 2176 samples were assessed during the study in November 2020 and October 2021, respectively; using the EpiData Software. Average compliance with section 4 of COTPA was highest in Puducherry during baseline [51.88%, prevalence ratio (PR)=0.72, 95% confidence interval (CI): 0.51-1.02] and in Telangana during endline assessment (66.1%, PR=0.6, 95% CI: 0.48-0.74). A visible change with section 5 of COTPA was observed in Telangana (40.08 to 93.12%, PR=0.04, 95% CI: 0.02-0.07). Compliance with section 6a of COTPA decreased in Puducherry (81.34 to 71.83%, PR=1.84, 95% CI: 1.14-2.95) and increased for Meghalaya and Telangana. The average compliance with sections 7, 8 and 9 (for Puducherry 51.09 vs . 48.8%, Meghalaya 54.94 vs . 46.18% and Telangana 73 vs . 51.91%, respectively) decreased in all States. An increase in average compliance was observed with sections 4 and 5 ( P =0.19 and 0.11, respectively) and a decrease with sections 7, 8 and 9 ( P =0.02) of COTPA in all three States. For sections 6a ( P =0.06) and 6b ( P =0.01), a mixed response was noted. The findings of this study suggest that the level of compliance with sections 4 and 5 of COTPA increased because they are strictly monitored compared to sections 7-9, which are less enforced by the States. There is a need to monitor sections 7-9 (pack warning) to fulfill the objectives related to the World Health Organization (WHO) Framework Convention on Tobacco Control.

Compliance with COTPA (Packaging and Labeling) Rules, 2008 and its amendments in smokeless tobacco products sold across Mangaluru taluk, Karnataka, India.

India introduced the Cigarettes and Other Tobacco Products Act (COTPA) (Packaging and Labeling [P and L]) Rules in 2008. These rules utilize the tobacco package to communicate tobacco-caused harms; it also seeks to restrict the delivery of misleading information about the product on the pack. The enormous burden of tobacco-related oral cancers in India necessitates the compliance with the law regarding presentation of information in powerful and salient ways, intentionally designed to increase the awareness in target individuals. The objectives of the study are to assess the compliance to implementation and enforcement of the COTPA (P and L) Rules, 2008 and its amendments in 2014 and 2018. Chewing tobacco products were retrieved and evaluated for compliance with the law. The specified pictorial and textual health warnings, area, clarity, rotation, and language were assessed as per the recommendations. Even though chewing tobacco products in India have introduced pictorial and textual health warnings, majority of them do not comply with the law. The products displayed the specified health warnings on a total of 70.6% on average, failing to abide by the government-specified average of 85%. 50% of the products did not follow the rotation of pictorial and textual health warning even after completion of the interregnum period of 12 months (September 2019). To ensure consumers' right to be informed about the health risks from a product, all the details regarding the contents, health warnings and messages, and product care instructions must be mentioned as specified under the law.

The association between the retail price of manufactured cigarettes and bidis on current smoking status in India.

INTRODUCTIONIn India, the retail prices of bidis and cigarettes varied between the two Global Adult Tobacco Surveys (GATS) conducted in 2009–2010 and 2016–2017. The relationship between the retail price of smoked tobacco products and their use is unclear for India. Our study thus aimed to use available datasets to investigate the association between the retail price and current smoking status of bidis and cigarettes in India.METHODSCurrent smoking status data for bidis and cigarettes were obtained from the two GATS rounds. The average state-level retail prices of bidis and cigarettes were obtained from India’s Consumer Price Index- Industrial Workers database. Descriptive statistics were used to describe current smoking status patterns. Generalized Linear Mixed Models were used to investigate the association between the retail prices and current smoking status of bidis and cigarettes.RESULTSFor cigarettes, an increase in the average retail price by one Indian Rupee was associated with a reduction in the odds of being a current smoker of 7% (OR=0.925; 95% CI: 0.918–0.932, p<0.001). For bidis, the association between the retail price and current smoking status was not statistically significant (OR=1.01; 95% CI: 1.00–1.02, p=0.082).CONCLUSIONSCurrent increases in the retail prices of tobacco products in India seem to have an impact on the use of cigarettes but not bidis. This highlights the need for tobacco product tax increases that result in sufficient retail prices increase to make all tobacco products less affordable and reduce their use.

Banning Loose Cigarettes and Other Tobacco Products in India: A Policy Analysis.

Sale of single cigarettes (also known as singles or loosies) is a key driver for early initiation of smoking and is a leading contributor to the smoking epidemic in India. Sale of singles additionally deter implementation of tobacco control strategies of pictorial health warnings including plain packaging and defeat effective taxation and promote illicit trade. We review India's tobacco control policy responses towards banning singles and other products sold as loose tobacco and identify opportunities for future policy intervention especially in the context of the ongoing COVID-19 pandemic. Existing national and sub-national policy documents were analyzed for their content since the inception of the tobacco control laws in the country. There are no effective provisions at national level to ban loose tobacco products in India. However, the implementation of multiple legislative and regulatory measures (Acts/circulars/letters/notifications/orders/court judgements) in 16 Indian states and jurisdictions provide sufficient legal framework to substantiate its complete ban pan India. While the majority of state governments have adopted state level measures, Rajasthan had issued specific directive to all the 33 districts banning loose cigarettes and other tobacco products. Himachal Pradesh introduced the most unique and comprehensive legislation, for banning the sale of cigarettes and beedis (Dated November 7, 2016). The most recent notification in the state of Maharashtra (September 24, 2020) is the first to leverage powers using a mix of national and state legislations including the legislation addressing the rapidly emerging challenge of managing COVID-19. A robust national policy which supports strong provision to deter tobacco companies, their distribution network and vendors from selling singles or loose tobacco products is urgently needed. Such policy should be backed by cautionary messaging for consumers as well. Eliminating singles and loose tobacco sale will help in blunting tobacco use prevalence besides curbing spread of infectious diseases like COVID-19 pandemic.

Strategic and contested use of food laws to ban smokeless tobacco products in India: a qualitative analysis of litigation

ObjectiveTo understand how food laws are used, contested and interpreted to ban certain forms of chewing tobacco in India.MethodsA qualitative study analysing all the tobacco-related litigation under the food laws...

Evaluating the Role of Media in Implementation of 85% Graphic Warnings on Tobacco Products in India

Abstract Background: In common with many countries globally, India has a history of graphic health warnings (GHWs) being weakened or delayed due to tobacco industry influence. If tobacco is eliminated from society, nearly 30% of all cancers can be prevented. Objectives: This study examines the role of the media in the recent changes to the 85% GHWs implementation in India. Materials and Methods: Media articles from the date of notification of 85% GHW (October 15, 2014) to the date of its implementation (April 1, 2016) were collected and coded as pro, anti, or neutral. These were compared, correlated to significant government actions during the time period to determine if media influenced the government actions on the implementation of GHWs. Results: A total of 3301 media articles regarding 85% GHWs were found during the study period, of which 2961 were pro, 333 were anti, and seven were neutral. The results showed that there was a positive correlation of media on the implementation of GHWs. Conclusion: Media coverage of the issue did appear to have an impact.

Changes in the affordability of tobacco products in India during 2007/2008 to 2017/2018: a price-relative-to-income analysis.

Increasing the price of tobacco through taxation is a very effective means of reducing tobacco use. However, the impact of price increases can be diluted if consumer incomes are growing strongly. The affordability of tobacco products has, therefore, become an important indicator for tobacco control. This study asks whether tobacco products in India became more or less affordable during 2007/2008 to 2017/2018. Survey data on the retail price of chewing tobacco, bidis and cigarettes were used to measure affordability at state and national levels. We adapted the price relative to income measure by calculating the percentage of net state domestic product (NSDP) per capita needed to purchase 1000 g of tobacco in each form and then calculating the average annual percentage change (AAPC) in affordability. We used ordinary least squares regression analysis to test for any changes. In 2017/2018, it took 1.72% and 1.18% of NSDP/capita to purchase 1000 g of tobacco in the form of bidis and chewing tobacco respectively. The affordability of bidis remained unchanged, while chewing tobacco became more affordable (AAPC = -1.83%, 95% confidence interval -2.87 to -0.80, P = 0.003). For cigarettes, it took 7.56% of NSDP/capita to purchase 1000 g of tobacco in 2017/2018; although affordability decreased in many states, national average affordability was unchanged. Tobacco products, especially indigenous forms such as bidis and chewing tobacco, have not become measurably less affordable over the past decade. India should raise taxes on all tobacco products to significantly reduce the affordability of these products and to promote public health.

Estimated impact of the GST on tobacco products in India

ObjectiveTo examine the potential impact of the goods and services tax (GST) on price, consumption and tax revenue from tobacco products in India and across states.MethodsData on prices, tax rates...

Goods and service tax reform and estimated impact on tobacco products in India

1. Smokeless tobacco taxation: Lessons from Southeast Asia RijoM John, Amit Yadav, DhirendraN Sinha Indian Journal of Medical Research CrossRef

Observational study to check the compliance of implementation of 85% graphic health warnings on tobacco products in India from April 1, 2016

1. A pilot study to assess compliance and impact of health warnings on tobacco products in the Udupi district of Karnataka State, India Somya Mullapudi, John Britton, Muralidhar Kulkarni, Crawford Moodie, Veena Kamath, Asha Kamath Tobacco Induced Diseases CrossRef

Productivity Growth Decomposition in the Manufacturing Industries of Food, Beverages, and Tobacco Products in India : A Stochastic Frontier Approach

The study applied stochastic production frontier approach to decompose the sources of total factor productivity growth (TFPG) of the organized manufacturing industries of food, beverages, and tobacco products in India into technological progress, changes in technical efficiency, economic scale effect, and allocative efficiency effect during the period from 1981-82 to 2010-11 during the entire period, during the pre- and post-reform period (1981-82 to 1990-91 and 1991-92 to 2010-11), and also, during two decades in the post-reform period (1991-92 to 2000-01 and 2001-02 to 2010-11) at the three-digit level of disaggregation of industries by NIC'04 and NIC'98. According to the estimated results, technological progress and allocative efficiency effect were the major contributors to TFPG of the organized manufacturing industries of food, beverages, and tobacco products in India during the study period from 1981-82 to 2010-11. Further, TFPG of the organized manufacturing industries of food, beverages, and tobacco products in India declined during the post-reform period (1991-92 to 2010-11), which is mainly accounted for by the decline in TP in this period, as our study revealed.

Using public interest litigation for tobacco control: Insights from India.

The Indian notion of "Public Interest Litigation (PIL)" represents a moral and humane process for providing justice to an individual or a group in matters relating to infringement of fundamental rights or denial of civil privileges. The goal of PIL in India is to counter governmental lawlessness, administrative deviance, and exploitation of disadvantaged groups by denying them their rights and entitlements. Although this paper selectively describes the use of the PIL mechanism for ensuring implementation of large graphic health warnings on packages of tobacco products in India, there is a sufficient published literature to corroborate the successful use of this mechanism in India in different tobacco control settings. In fact, over the years, this legal tool has allowed the tobacco control community in India, to extensively promote human rights approach to tobacco control. In the wake of growing interference of tobacco industry worldwide, this paper explores PIL as a potent and effective tool for claiming public health rights related to tobacco control. The PIL has considerable potential to be used for enforcement of tobacco control measures and for stopping tobacco industry from engaging in activities which are detrimental to the health of the people at large. It is important to continuously identify potential avenues through which lessons and recommendations pertaining to PIL could be incorporated into the WHO Framework Convention on Tobacco Control implementation plans and guidelines, with special focus on different intercessional mechanisms that are available from time to time. To set the ball rolling, the authors suggest two such avenues.

A Two-Wave Observational Study of Compliance With Youth Access and Tobacco Advertising Provisions of the Cigarettes and Other Tobacco Products Act in India.

The Indian Cigarettes and Other Tobacco Products Act prohibits youths' access to tobacco products at points-of-sale and near educational institutions, requires signage stating these restrictions in these venues, and bans outdoor advertisements. This observational study examined compliance with these provisions, changes in compliance over 1 year, and factors associated with compliance. Data were collected in 2012 and 2013 from points-of-sale (n = 555 in 2012, n = 718 in 2013), educational institutions (n = 277 in 2012, n = 276 in 2013), and neighborhoods (n = 104 in 2012, n = 125 in 2013) in 25 urban and rural towns in five states. Compliance across years was compared using chi-square tests. Multilevel regression equations assessed factors associated with compliance at Wave 2 and change in compliance from Wave 1 to Wave 2. Most points-of-sale had no/low compliance, with little change over time (58% to 63%, P = .108). The proportion of educational institutions observing just 1-2 provisions increased (39% to 52%, P = .002). Most neighborhoods complied with the advertisement ban at both waves (91% to 96%, P = .172). In the multilevel analysis, point-of-sale compliance increased in small cities; compliance decreased at points-of-sale and increased at institutions in mid-sized cities. Changes in point-of-sale compliance were due to compliance with access restrictions and signage requirements; changes in educational institution compliance were due to compliance with the sales ban. Compliance with provisions regarding the sale and display of tobacco products is moderate, while compliance with the advertisement ban remains high in these five Indian states. Greater enforcement will further reduce youths' exposure to tobacco products. The study adds to the literature on compliance and changes in compliance with policy to prohibit youth access to tobacco products in India, a country that has large geographic disparities in youth smoking prevalence. The findings highlight several important areas on which efforts can focus to improve compliance among points-of-sale, educations institutions, and neighborhoods to limit youths' exposure and access to tobacco products. Rural areas and large cities in particular need more concerted efforts.

Nicotine quantity and packaging disclosure in smoked and smokeless tobacco products in India.

Objectives:A variety of smoked and smokeless tobacco products with varying nicotine content are accessible in India. Nicotine quantity in tobacco products has direct bearing on tobacco dependence. Our objective was to estimate nicotine content in various types of smoked and smokeless products. Disclosure for essential health warning was also checked.Materials and Methods:Liquid-liquid extraction was used for nicotine extraction and high-performance thin layer chromatography technique was applied for quantification of nicotine in seventy-one smoked and smokeless tobacco products.Results:Significant variation in nicotine content was observed across products. In smoked tobacco, nicotine content varied from 1.01 to 13.0 mg/rod, while in smokeless tobacco products it ranged from 0.8 mg/g to 50.0 mg/g. Moisture content varied from 9% to 21%.Conclusion:This work lists a range of smoked and smokeless tobacco products available in this region. We report a wide variability in nicotine quantity across smoked and smokeless tobacco products. Such variation in nicotine content may have important implications for tobacco cessation interventions and policies

Anti-tobacco Messages on Tobacco Products in India: Do They Really Hit the Mark?

The Indian Government has recently introduced various fiscal and nonfiscal measures for tobacco control, including pictorial health warnings on tobacco packaging. Health warnings on tobacco products are arguably the most cost-effective tool for educating on the health risks of tobacco use. However, interventions are effective upon being transferred from one setting to another with appropriate adjustment to the local context. Authors argue that there is a need to strengthen and target the health messages in a better way to ensure that the warnings reach all smokers, including those buying loose cigarettes/bidis. Any measures that make anti-tobacco messages more meaningful in the Indian context will lead to significant contributions towards the fight against tobacco.

Implementation of graphic health warning labels on tobacco products in India: the interplay between the cigarette and the bidi industries

ObjectivesTo understand the competition between and among tobacco companies and health groups that led to graphical health warning labels (GHWL) on all tobacco products in India.MethodsAnalysis of internal tobacco industry...

Awareness of pro-tobacco advertising and promotion and beliefs about tobacco use: Findings from the Tobacco Control Policy (TCP) India Pilot Survey

Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (p<0.01). The findings from this study reiterate the need for stronger legislation and strict enforcement of bans on direct and indirect advertising and promotion of tobacco products in India.

Tobacco industry co-optation of culture? Converging culturally specific and mainstream tobacco products in India

Snus is a moist tobacco product containing finely chopped tobacco in a tea bag-like pouch, which is placed under the lip for consumption.1 Snus proponents claim that it is a...