Tobacco Vendors Research Articles

Prevalence and factors associated with the sale of loose cigarettes at Point of Sale: A cross-sectional analytical study from four Indian states

BackgroundThe Framework Convention on Tobacco Control (FCTC) has established that sale of loose cigarettes increases the affordability and accessibility of tobacco for minors. Acknowledging this threat to public health, the Department of Consumer Affairs, Government of India amended the Legal Metrology Act to prohibit sale of loose cigarettes. Regardless, over 70% of the total cigarette sale in the country is in the form of loose cigarettes majority of which is being sold at unrecognized, unrecorded and unregulated informal sector of economy. However, there is a paucity of studies examining the factors associated with sale of loose cigarettes and further research is warranted in the country to know the dynamics of this issue. ObjectiveTo determine the prevalence and the factors associated with the sale of loose cigarettes at Point of Sale (PoS) in the selected four Indian states. MethodsA community based cross-sectional analytical study was conducted among a total of 2044 PoS in the project states of Meghalaya, Odisha, Puducherry and Telangana using purposive sampling technique. The characteristics of tobacco vendors and the status of loose cigarettes sale were collected using a structured and pre-tested checklist. Proportion for prevalence estimate, bivariate and multivariable log binomial regression analysis were done. ResultsThe prevalence of loose cigarette sale was 93.05% [95% CI: 91.89–94.1]. Sale of loose cigarette showed a significant association with area (aPR 1.03; 95% CI: 1–1.06; p = 0.025), sale of tobacco products to minors (aPR 1.07; 95% CI: 1.04–1.11; p < 0.001), sale of smoking aids to customers (aPR 1.05; 95% CI: 1.01–1.09; p = 0.02), sale of flavored chewable tobacco (aPR 1.08; 95% CI: 1.03–1.12; p = 0.001) and presence of pack warning (aPR 1.18; 95% CI: 1.11–1.25; p < 0.001). ConclusionOur findings infer an open disregard for the laws specific to sale of loose cigarettes at PoS. The factors associated with the sale of loose cigarette needs to be addressed through prompt implementation of the tobacco control laws and suitable policy formulation.

Chennai tobacco vendors compliance to India's cigarette and other tobacco products Act (COTPA) 2003- A descriptive evaluation.

Chennai tobacco vendors compliance to India's cigarette and other tobacco products Act (COTPA) 2003- A descriptive evaluation.

Communicating risk: Status of health warning labels on various tobacco products in Indian market

BackgroundOwing to the role of tobacco packaging as a strong medium of communication, display of health warnings on tobacco packs effectively impart health risks of tobacco consumption to those currently using or contemplating the use of tobacco. MethodsThis community based cross-sectional analytical study was conducted among 2044 tobacco product packs, each collected from a different PoS, to estimate the non-compliance of section 7, 8 & 9 of COTPA among various tobacco products and its association with the PoS characteristics. Data were collected by observation of PoS by field investigators and then purchase of a unique product from each vendor followed by a brief interview of the tobacco vendor. ResultsThe study documented an absence of health warning label on 15.51% [95% CI: 13.99–17.13] of the total 2044 tobacco products collected. The non-compliance to ‘quality of health warning picture’ was lowest 5.96% [95% CI: 4.91–7.16] among the tobacco products with a health warning label. The multivariate regression model revealed that absence of health warning on tobacco product packs were higher among the PoS in rural area (aPR 1.38; 95% CI: 1.16–1.65; p < 0.001) and among street/mobile vendors (aPR 1.65; 95% CI: 1.22–2.24; p = 0.001). The PoS not displaying tobacco products (aPR 1.36; 95% CI: 1.08–1.72; p = 0.01), selling flavored chewable tobacco (aPR 1.67; 95% CI: 1.24–2.27; p = 0.001), not selling loose cigarettes (aPR 2.93; 95% CI: 1.94–4.43; p < 0.001) and with vendors not enquiring age proof (aPR 10.69; 95% CI: 1.59–72.09; p < 0.001) had higher proportion of tobacco products without health warning labels. A greater proportion of smokeless/local variety tobacco products (aPR 18.06; 95% CI: 12.31–26.51; p < 0.001) had absence of health warning label. ConclusionThe data provided by us have clear policy implications. We recommend regular enforcement activities to monitor the presence of health warning labels on tobacco product packs along and accurate printing of the same with adherence to the Ministry of Health and Family Welfare templates.

Nitrogen Application Modifies the Seed and Oil Yields and Fatty Acid Composition of Nicotiana tabacum

Tobacco is traditionally an industrial crop that is used for manufacturing cigarettes. However, due to health concerns and global tobacco control movements, alternative uses of tobacco are urgently needed to support tobacco farmers and vendors. Tobacco is also an oilseed crop with an oil yield ranging from 30% to 40 of its dry weight. However, there is still no information on the effects of nitrogen application on tobacco seed yield and seed oil production. The objective of this study was to evaluate the effects of N fertilization (90, 120, 150, and 180 kg·ha−1 N) on the seed yield, oil content, fatty acid composition, and seed germination characteristics of tobacco plants at two locations. The results showed that applying increasing amounts of N to tobacco plants significantly increased their total seed yields and oil content. Nitrogen application also modified the fatty acid composition of the seed oil, as more unsaturated fatty acids were produced under the increasing N application rate treatments than under the control. Moreover, increasing the N application rate generally significantly increased the yields of individual fatty acids as well. Nevertheless, the increased seed oil content and altered fatty acid composition did not affect seed germination traits, as the seed germination potential and rate showed no obvious change among treatments or the control. The height and size of the tobacco plants also increased with the increasing N application rate, which would be beneficial for increasing biomass production for bioenergy. This study shows for the first time the feasibility of increasing the seed and oil yields and modifying the fatty acid composition of tobacco plants by increasing N addition.

Ban on Sale of Loose Cigarettes: Awareness, Perceptions and Practices among Vendors and Smokers in Karnataka, India

Background: The Government of Karnataka banned loose cigarettes sale effect from September 2017 and is punishable under Cigarettes and Other Tobacco Products Act (COTPA) with fine and imprisonment in case of violation. Aim &amp; Objective: Study aims to assess awareness, perceptions and practices about ban among tobacco vendors and smokers. Methods and Material: Cross sectional survey was carried using pre-tested questionnaire to collect information regarding awareness about ban among vendors and smokers. Data were analyzed using SPSS version 15.0. Results: Ninety-five percent of the tobacco vendors continued to sell loose cigarettes despite the ban. Among vendors, 49.7%, were aware of ban and of them 53.5% knew it is a punishable offense. Vendors opined that they would stop selling loose cigarettes if ban is strictly enforced with frequent checks on periodical basis. One-fourth smokers opined they will reduce cigarettes consumption with few making an attempt to quit. Conclusions: Awareness about ban on sale of loose cigarettes was unsatisfactory among vendors and smokers including lack of knowledge regarding legal actions in case of violation. However, vendors responded favorably towards obeying the law. Smokers are likely to reduce or even quit smoking if the law is strictly enforced which highlights the need for creating awareness drives and strong enforcement of the policy.

The availability of retail tobacco near federally qualified healthcare facilities and addiction treatment centers in New York State.

The effectiveness of tobacco control policies that create smoke-free healthcare facilities and encourage the delivery of tobacco dependence treatment may be undermined by the availability of retail tobacco in the surrounding environments. This study examined the availability of retail tobacco in relation to: federally qualified health centers and look-a-like (FQHC/LAL) healthcare facilities (n = 706) as well as substance abuse and addiction treatment centers (n = 953) across New York State (NYS) in 2018. A statewide tobacco retailer density surface using static-bandwidth kernel density estimation was constructed from geocoded licensed tobacco vendors (n = 21,314). For each healthcare facility, tobacco retailer density (retailers per square mile) was extracted from the underlying NYS density surface. Proximity from each healthcare facility to the nearest tobacco vendor was calculated in walkable miles. Across NYS, tobacco retailer density ranged from 0 to 41.02 retailers per square mile. The availability of retailer tobacco near FQHC/LAL healthcare facilities and substance abuse and addiction treatment centers was higher in metropolitan areas than less urban areas as expected. School-based FQHC/LAL healthcare facilities had higher density than all other FQHC/LAL healthcare facilities types (Mean = 20.82 vs. 17.04, p = 0.0042), while opioid abuse and addiction treatment centers had on average higher density (Mean = 20.42 vs. 9.81, p < 0.0001) and closer proximity to a tobacco vendor (Mean = 0.14 vs. 0.36, p < 0.0001) than other substance abuse and addiction treatment centers. State and local tobacco control retailer reduction policies should be considered to reduce the availability of retail tobacco surrounding these facilities.

P1.10-05 Tobacco Retail Availability and Tobacco Cessation Among Lung Cancer Survivors

Continued smoking after a lung cancer diagnosis is associated with poorer outcomes. Tobacco retail availability is negatively associated with cessation in non-cancer patients but this has not been explored in cancer survivors. We evaluated the impact of tobacco retail availability on tobacco cessation in lung cancer survivors. Lung cancer survivors from Princess Margaret Cancer Centre (Toronto, Canada) completed questionnaires at diagnosis and follow-up evaluating changes in tobacco use with a median of 26 months apart. Validated tobacco retail location data were obtained from Ministry of Health and patient home addresses were geocoded using ArcGIS 10.6.1, which calculated walking time/distance to nearest vendor, and vendor density within 250 meters (m) and 500m from patient residences. Multivariable logistic regression and Cox proportional hazard models evaluated the impact of vendor availability on cessation and time to quitting after diagnosis respectively, adjusting for significant clinico-demographic and tobacco covariates. 242/721 lung cancer survivors smoked at diagnosis; subsequent overall quit rate after diagnosis was 66%. Mean distance and walking time to a vendor was 0.8 km (range 0-13) and 10 min (range 0-157). On average, there was one vendor (range 0-19) within 250m and five vendors (range 0-36) within 500m from pts; 40% and 64% of pts lived within 250m and 500m from at least one vendor respectively. Greater distance (aOR 1.28 per 1000m [95% CI 0.97-1.70] p = 0.08) and increased walking time (aOR 1.02 per minute [1.00-1.05] p = 0.08) to a tobacco vendor had a non-significant trend towards increased chances of quitting at one year. Living within 250m (aOR 0.43 [0.25-0.74] p = 0.003) or 500m (aOR 0.50 [0.28-0.88] p = 0.02) to at least one vendor reduced quitting at one year. Living near more vendors within 500m had a non-significant trend towards having an increasing dose effect on reducing cessation rates at one year (aOR 0.97 per vendor [0.94-1.00] p = 0.08). Living within 500m to a vendor reduced chance of quitting at any time (aHR 0.70 [0.50-1.00] p = 0.05). Close proximity to tobacco retail outlets is associated with reduced cessation rates for lung cancer survivors. Reducing density of tobacco vendors is a cessation strategy that could positively impact lung cancer patient outcomes.

1827P - Tobacco retail access and tobacco cessation among head and neck cancer (HNC) survivors

BackgroundContinued smoking after a HNC diagnosis is associated with poorer outcomes. Proximity to tobacco retail outlets is negatively associated with cessation in non-cancer patients (pts) but this has not been evaluated in cancer survivors. We evaluated the impact of tobacco retail access on cessation in HNC pts. MethodsHNC pts (Princess Margaret Cancer Centre, Toronto, Canada) completed questionnaires at diagnosis and follow up (median 26 months apart) evaluating changes in tobacco use. Validated tobacco retail location data were obtained from Ontario Ministry of Health and pt home addresses were geocoded using ArcGIS 10.6.1, which calculated walking time/distance to nearest vendor and vendor density within 250 meters (m) and 500m from pts. Multivariable logistic regression and Cox proportional hazard models evaluated the impact of vendor availability on cessation and time to quitting after diagnosis respectively, adjusted for significant clinico-demographic and tobacco covariates. Results141/450 HNC pts smoked at diagnosis; quit rate after diagnosis was 48%. Mean distance and walking time to a vendor was 1.2km (range 0-10) and 14min (range 0-116). On average, there was 1 vendor (range 0-19) within 250m and 3 vendors (range 0-19) within 500m from pts; 33% and 56% of pts lived within 250m and 500m from at least one vendor, respectively. Greater distance (aOR 1.27 per 1000m [95% CI 1.01-1.59] p=0.04) and increased walking time (aOR 1.02 per min [1.00-1.04] p=0.04) to a vendor were associated with a higher quit rate at one year. Living near more vendors within 500m was associated with an increasing dose effect on reducing cessation rates at 1 year (aOR 0.90 per vendor [0.82-0.99] p=0.03). Greater distance (aHR 1.18 per 1000m [1.01-1.38] p=0.04) and increased walking time (aHR 1.01 per min [1.00-1.03] p=0.04) to a vendor were also associated with quitting at any time. Living near more vendors within 500m had a trend towards reducing quit rates at any time (aHR 0.94 per vendor [0.88-1.00] p=0.07). ConclusionsClose proximity to tobacco retail outlets is associated with reduced cessation rates for HNC survivors. Reducing density of tobacco vendors is a cessation strategy that can positively impact HNC pt outcomes. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Identification of Policy Priorities to Address the Burden of Smokeless Tobacco in Pakistan: A Multimethod Analysis.

IntroductionWe assessed the magnitude of smokeless tobacco (ST) use in Pakistan and identified policy gaps to help ascertain short-, medium-, and long-term priorities. We then elicited stakeholders’ views as to which of these identified priorities are most important.MethodsIn a multimethod study, we: analyzed Global Tobacco Surveillance System data sets to estimate ST consumption and disease burden; conducted a documentary review to identify gaps in policies to control ST in comparison with smoking; elicited stakeholders’ views in an interactive workshop to identify a set of policy options available to address ST burden in Pakistan; and ranked policy priorities using a postevent survey.ResultsAmong all tobacco users in Pakistan (n = 24 million), one-third of men and two-thirds of women consume ST. In 2017, its use led to an estimated 18 711 deaths due to cancer and ischemic heart disease. Compared to smoking, policies to control ST lag behind significantly. Priority areas for ST policies included: banning ST sale to and by minors, advocacy campaigns, introduction of licensing, levying taxes on ST, and standardizing ST packaging. A clear commitment to close cooperation between state actors and stakeholder groups is needed to create a climate of support and information for effective policy making.ConclusionsSmokeless tobacco control in Pakistan should focus on four key policy instruments: legislation, education, fiscal policies, and quit support. More research into the effectiveness of such policies is also needed.ImplicationsA number of opportunities to improve ST regulation in Pakistan were identified. Among these, immediate priorities include banning ST sale to and by minors, mobilizing advocacy campaign, introduction of licensing through the 1958 Tobacco Vendors Act, levying taxes on ST, and standardizing ST packaging.

Tobacco retail availability and tobacco cessation in lung and head and neck (HN) cancer survivors.

11559 Background: Continued smoking after a cancer diagnosis is associated with poorer outcomes. Tobacco retail availability is negatively associated with cessation in non-cancer patients (pts), but has not been explored in cancer survivors. We evaluated the impact of tobacco retail availability on cessation in lung and HN cancer pts. Methods: Lung and HN cancer pts (Princess Margaret Cancer Centre, Toronto) completed questionnaires evaluating changes in tobacco use with a median of 26 months apart. Validated tobacco retail location data were obtained from Ministry of Health and pt home addresses were geocoded using ArcGIS 10.6.1, which calculated walking time/distance to nearest vendor, and vendor density within 250 meters (m) and 500m from pts. Multivariable logistic regression and Cox proportional hazard models evaluated the impact of vendor availability on cessation and time to quitting after diagnosis respectively, adjusting for significant clinico-demographic and tobacco covariates. Results: 242/721 lung and 149/445 HN pts smoked at diagnosis; subsequent overall quit rates were 66% and 49% respectively. Mean distance and walking time to a vendor was 1 km (range 0-13) and 11 min (range 0-156). On average, there was one vendor (range 0-19) within 250m and four vendors (range 0-40) within 500m from pts; 37% and 61% of pts lived within 250m and 500m from at least one vendor respectively. Greater distance (aOR 1.18 per 1000m [95% CI 1.00-1.38] p = 0.05) and increased walking time (aOR 1.01 per minute [1.00-1.02] p = 0.05) were associated with quitting at one year. Living within 250m (aOR 0.52 [0.32-0.84] p = 0.008) or 500m (aOR 0.57 [0.35-0.92] p = 0.02) to at least one vendor reduced quitting at one year. Living near more vendors within 500m had an increasing dose effect on reducing cessation rates at one year (aOR 0.96 per vendor [0.93-1.00] p = 0.05). Living within 500m to a vendor reduced chance of quitting at any time (aHR 0.66 [0.48-0.91] p = 0.01). HN and lung subgroups revealed similar associations. Conclusions: Close access to tobacco retail outlets is associated with reduced cessation rates for lung and HN cancer survivors. Reducing density of tobacco vendors is a cessation strategy that can positively impact cancer pt outcomes.

COTPA 2003 compliance assessment of tobacco vendors and products: current status of an earliest smoke free Indian city

Background: Tobacco smoking is a global phenomenon, associated not only with health but also with other issues like employment, trade and revenue. However, the ill aspects of tobacco outweigh any productivity related to it. Various regulatory measures have been devised to control this menace at national as well as international level. In India, COTPA-2003 legislation intends to control and regulate tobacco consumption, advertisement and trade.Methods: The present study assessed the compliance of 157 points of sale and 59 tobacco products to the Sections 5,7,8,9 and 10 of the smoke free legislation using a structured observational checklist.Results: In total (41%) POS were advertising tobacco in one or other form with product showcasing (64%) being the most common modality of advertisement. Actual advertisement boards were seen at only 14.6% of POS. About 87% of the advertisement boards carried a health warning. Loose cigarettes were being sold at about 77% of the POS. All tobacco products available in the city were observed to display good compliance; however none of the smoke product displayed nicotine and tar content on the pack.Conclusions: Negligible number of PoS was seen to display an actual advertisement. Almost all tobacco products displayed good compliance to the Act. The striking shortcoming was the absence of nicotine and tar content on the package of the product even after 16 years of enactment. Discrepancies need to be addressed appropriately supplemented with aggressive monitoring of adherence to the Act in order to sustain the smoke free status of the city.

Compliance with point-of-sale tobacco control policies and student tobacco use in Mumbai, India

BackgroundWe measured how student tobacco use and psychological risk factors (intention to use and perceived ease of access to tobacco products) were associated with tobacco vendor compliance with India’s Cigarettes...

Compliance and awareness of Cigarettes and Other Tobacco Products Act among tobacco sellers in urban Ludhiana

Background: Tobacco use is one of the major preventable causes of deaths globally. Although India responded early to combat this global problem by implementing Cigarettes and Other Tobacco Products Act (COTPA), there is a need to evaluate its implementation. Objective: The objective of this study was to assess the compliance and awareness of the tobacco vendors to Section 5 (Point of sale advertisements of Cigarettes and Other Tobacco Products) and Section 6 (Prohibition on sale to minors and within 100 yards of educational institutes) of COTPA. Materials and Methods: The present study was a community-based cross-sectional study. All tobacco selling stores located within 100 yards distance from 58 educational institutes in urban Ludhiana were assessed for compliance to Section 5 and 6 provisions of COTPA. The study also assessed awareness regarding COTPA legislation among the tobacco vendors available in these tobacco selling stores. Data were collected using a semi-structured questionnaire. The questions were asked to determine the level of awareness of COTPA among the tobacco vendors. Results: Around 42.0% of the educational institutes had tobacco stores located within 100 yards and only around 25.0% of educational institutes had mandatory signage prohibiting ban on selling tobacco products displayed outside institutions. Most of the tobacco outlets (77.7%) were permanent, exclusive tobacco sellers (72%) and had displayed the products enabling easy access to minors. Majority (89%) of the vendors knew about an act regarding tobacco products. However, only 19.4% and 25% of vendors were aware of ban on selling tobacco products within the radius of 100 yards of educational institutions and to minors, respectively. Conclusion: Strict enforcement of the provisions of COTPA around educational institutes to reduce easy access of tobacco products to minors and strengthening awareness generation activities by involving key stakeholders is needed.

Compliance of Cigarettes and Other Tobacco Products Act among Tobacco Vendors, Educational Institutions, and Public Places in Bengaluru City

AbstractBackground: Tobacco has been the arch criminal of most head-and-neck cancers in the world. Many laws have been implemented to control this menace, but still this slow poison persists. Effectiveness of these laws has always been a matter of concern to the authorities. The present study was conducted to observe the compliance of Cigarettes and Other Tobacco Products Act (COTPA) among public places, educational institutions, and tobacco vendors in Bengaluru city. Methodology: A cross-sectional, observational study was done to assess the violations at public places, educational institutions, and tobacco vendors. Violations for Sections 4, 5, 6, and 7 of COTPA were assessed from 25 each of these places in the eight zones of Bengaluru city. The study areas were chosen by convenience sampling method, and using a questionnaire, the violations were recorded. Data were analyzed in Microsoft Excel to find out the percentage of violations. Results: The COTPA Sections 4 and 5 violation was 134 (67%) and 94 (47%), respectively. A total of 124 (62%) of the educational institutions had tobacco vendors within 100 yards, and only 30 (15%) had signboard for the prohibition of tobacco use. Around 14 tobacco vendors had beedis without proper pictorial warning with them which violated Section 7 of COTPA. Conclusion: For proper implementation of COTPA laws, we should create awareness about the laws, what amounts to violations and also the health hazards to tobacco use among general population. The law enforcing personnel should act on those who violate the law. There is a need for a sensitization workshop and advocacy for all the stakeholders.

Longitudinal study of adolescent tobacco use and tobacco control policies in India

BackgroundThis project will use a multilevel longitudinal cohort study design to assess whether changes in Community Tobacco Environmental (CTE) factors, measured as community compliance with tobacco control policies and community density of tobacco vendors and tobacco advertisements, are associated with adolescent tobacco use in urban India. India’s tobacco control policies regulate secondhand smoke exposure, access to tobacco products and exposure to tobacco marketing. Research data about the association between community level compliance with tobacco control policies and youth tobacco use are largely unavailable, and are needed to inform policy enforcement, implementation and development.MethodsThe geographic scope will include Mumbai and Kolkata, India. The study protocol calls for an annual comprehensive longitudinal population-based tobacco use risk and protective factors survey in a cohort of 1820 adolescents ages 12–14 years (and their parent) from baseline (Wave 1) to 36-month follow-up (Wave 4). Geographic Information Systems data collection will be used to map tobacco vendors, tobacco advertisements, availability of e-cigarettes, COTPA defined public places, and compliance with tobacco sale, point-of-sale and smoke-free laws. Finally, we will estimate the longitudinal associations between CTE factors and adolescent tobacco use, and assess whether the associations are moderated by family level factors, and mediated by individual level factors.DiscussionIndia experiences a high burden of disease and mortality from tobacco use. To address this burden, significant long-term prevention and control activities need to include the joint impact of policy, community and family factors on adolescent tobacco use onset. The findings from this study can be used to guide the development and implementation of future tobacco control policy designed to minimize adolescent tobacco use.

Licensing tobacco vendors in the state of Himachal Pradesh in India - challenges, opportunities and the way forward to implement the new legislation

1. Smokeless tobacco control in India: policy review and lessons for high-burden countries Amit Yadav, Prashant Singh, Nisha Yadav, Ravi Kaushik, Kumar Chandan, Anshika Chandra, Shalini Singh, Suneela Garg, Prakash Gupta, Dhirendra Sinha, Ravi Mehrotra BMJ Global Health CrossRef

Internet little cigar and cigarillo vendors: Surveillance of sales and marketing practices via website content analysis

IntroductionCigar sales have nearly doubled as cigarette sales have dropped, and large cigars have been replaced by little cigars and cigarillos (LCCs). Many LCCs are flavored, are perceived as less harmful than cigarettes, and have become increasingly available from e-commerce sources. We conducted surveillance of the online retail environment in 2013 and 2014 for LCCs in order to describe characteristics of Internet tobacco vendors selling LCCs and their sales and marketing practices, youth access practices, and their practices in relation to cigarette and other tobacco product sales. MethodsIn 2013, we identified and manually screened 32,446 websites, yielding 500 unique Internet LCC vendors. In 2014, we identified 511 vendors selling LCCs from a list of 31,239 manually screened websites. We then selected 249 in 2013 and 263 in 2014 for content analysis focusing on six domains including demographics, youth access, payment and delivery, products for sale, promotions and claims, and prices. ResultsJust over half of vendors in both years were located solely in the U.S. with 70.1% of those selling flavored LCCs in 2013 and 76.1% in 2014. Nearly half only used proven ineffective age verification strategies and another 10% made no attempts to verify age at all. Most vendors accepted credit cards and advertised using the United States Postal Service. Half of vendors featured a variety of health warnings and most featured promotions. ConclusionsFederal bans on flavored cigarettes and restrictions on age verification, payment, and shipping for Internet tobacco sales should be extended to include LCCs.

The tobacco trade and trail in Karnataka.

Tobacco use is a major public health challenge in India with 275 million adults consuming different tobacco products. Despite innumerable laws, the overall picture of the current system is not clear and the menace of tobacco persists. What does it take to stop this menace? The present study made an attempt to throw some light on the prevailing discrepancy in the current system. The aim of the study was to explore the knowledge and attitude of people involved in growth and sales of tobacco. This qualitative research was aimed at farmers growing tobacco in Mysore district and vendors selling tobacco in Bangalore. Snowball sampling technique was used to select the farmers. Simple random sampling technique was used to shortlist vendors selling tobacco products in Bangalore. Data were collected using semistructured questionnaire through interviews which were recorded using an audio recorder. Inductive analysis was conducted for the present study and the responses were divided into three categories, that is, awareness of laws, compliance to laws, and opinion regarding banning tobacco. Ninety percent of the growers and all the tobacco vendors (100%) were aware of the laws governing them; however, the compliance was poor in both the populations (32% and 20%, respectively). Implementation of law is an area that needs to be strengthened. Violations of these laws are not adequately reported; this matter should be dealt with. It was seen that the system which creates the laws itself promotes the growth and thereby the distribution of the tobacco products.

A Neighborhood Analysis of Underage Tobacco Sales within the Serving Area of a Canadian Public Health Unit

Despite the fact that the sale of tobacco to minors is illegal in Ontario, youth are still able to purchase tobacco. This study aims to determine the geographic variations of underage tobacco sales at the neighborhood level within the Windsor-Essex County Health Unit. Data were collected on all inspections of tobacco retail stores from 2007 to 2011 in the Windsor-Essex County Health Unit. Data were split into season 1 (September-February) and season 2 (March-August) to assess a possible seasonal effect. Relative risks were calculated for each dissemination area (DA) by modeling the risks in a hierarchical Bayesian fashion, incorporating appropriate random effects terms for both spatially correlated and uncorrelated random errors with adjustments for neighborhood income. The association between violation rate and proximity to a school was assessed through a buffer analysis. Elliptical analysis detected a significant cluster of high risk DAs in season 1 in Windsor (p-value = 0.022) but no significant cluster in season 2. Some DAs exhibited higher relative risks of tobacco sales to minors, however after adjusting the model for neighborhood income no excess risk was observed. The results of the buffer analysis showed that in season 1 there was a significantly higher probability (p-value = 0.045) of tobacco vendors located closer to schools to sell tobacco to minors. This analysis demonstrates the utility of a systematic approach to identifying neighborhoods with higher risks of tobacco sales to minors. The insights provided by this exploratory, ecologic study are valuable for program planning and directing tobacco enforcement efforts to high risk areas.

What is included with your online e-cigarette order? An analysis of e-cigarette shipping, product and packaging features

BackgroundThe electronic cigarette industry is growing, with youth using e-cigarettes at higher rates than they are using cigarettes, and retail and online sales projected to reach $10 billion in 2017....