Tobacco Vendors Research Articles

"The ban is there, but it is not there": perceptions of cigarette users and tobacco vendors regarding ban on the sale of loose cigarettes in India.

Banning the sales of loose cigarettes is recommended by Article 16 of the World Health Organization - Framework Convention on Tobacco Control. This study aims to understand the perceptions of cigarette users and tobacco vendors regarding such a ban. Using a systematic recruitment and interview protocol, we interviewed cigarette users (n = 28) and tobacco vendors (n = 28) from two Indian cities where sales of loose cigarettes were banned (Mumbai) or not banned (Delhi). Separate semi-structured interview guides were used for users and vendors. Interview questions focused on reasons for purchasing loose cigarettes, preference for buying and selling loose vs. packs, thoughts on the necessity of banning loose cigarettes, and the perceived impact of the policy ban for vendors and cigarette users. We performed thematic analysis and used NVivo for organizing transcript coding. The main reasons users cited for purchasing loose cigarettes were financial constraints, social restrictions (fear of getting caught), and limiting cigarette consumption. In Mumbai, awareness of the existing ban was poor among both users and vendors. Those who were aware did not think the policy had been implemented. Users thought that loose cigarettes promoted smoking initiation and prevented them from quitting. Both users and vendors reported that a ban on loose cigarettes would reduce cigarette consumption and promote quit attempts as it would not be possible for everyone to purchase packs because of financial and social reasons. Users in both cities reported easy access to and widespread availability of loose cigarettes. Low awareness of the ban in Mumbai suggested inadequate enforcement. A country-wide ban on the sale of loose cigarettes could be highly effective in preventing smoking initiation and promoting quitting.

Knowledge, perception, and practices of teaching and nonteaching staff members regarding tobacco use surveillance before and after implementing the Tobacco-Free School Program: A serial cross-sectional study

Abstract Aims and Objectives: The present study assessed the knowledge, perceptions, and behaviors related to tobacco use surveillance among both teaching and nonteaching staff members before and after implementing the “Tobacco Free School” intervention. This initiative targeted establishing tobacco-free environments, specifically in Marathi medium-high schools within the Pimpri-Chinchwad Municipal Corporation, Pune District, Maharashtra, India. Materials and Methods: Data for the serial cross-sectional study were gathered using a validated questionnaire administered to teaching and nonteaching staff members at these schools at baseline and follow-up. The intervention was conducted in three schools between June 2019 and September 2020. The number and percentage for each question concerning knowledge, perception, and practice were calculated with a confidence interval of 95% and a P value of <0.05 considered significant. The McNemar test was employed to assess whether there was a significant difference between pre- and post-study results. Results and Discussion: Ninety percent of teachers demonstrated awareness of the law. Familiarity with two specific sections of Cigarettes and Other Tobacco Products Act 2003: Sections 4 and 6 showed a 39% difference in knowledge acquired between pre- and post-study results. Staff members were better aware of the tobacco vendors setting up shop outside the educational institution post-survey (P = 0.03). Conclusion: Staff members learned about tobacco products’ content, ill effects, and better-perceived tobacco control. Based on the respondent’s reply (61%) on the presence of tobacco vendors within 100 yards, the offending vendor’s picture was uploaded on the “Tobacco Monitor App” so that prompt action could be initiated by the State Tobacco Control Cell.

PATTERN OF TOBACCO SALE AND CONSUMPTION IN BATHINDA, PUNJAB - A CROSS SECTIONAL STUDY

The objective of this study is to study the patterns of tobacco sale and to assess the knowledge of tobacco vendors about health hazards from tobacco consumption in Bathinda, Punjab. The present cross sectional study was conducted for a period of 2 months on 374 vendors near the institutional areas of Bathinda city and around. Vendors who gave consent and had temporary or permanent stalls/shops selling tobacco products were included in the study. Around 500 vendors were approached out of which 374 were included in the study. Data collection included a face to face interview and the information gathered was filled in a pretested and pre validated questionnaire.

Tobacco Vendors' Perceptions and Compliance with Tobacco Control Laws in Nigeria.

Tobacco vendors are critical stakeholders in the tobacco supply chain. This study examined their perception, compliance, and potential economic impact of Nigeria's tobacco control laws related to the retail setting. This was a qualitative study involving in-depth interviews of 24 purposively selected tobacco vendors. The face-to-face interviews were aided by a semi-structured interview guide, audio-recorded, transcribed verbatim, and analyzed using thematic analysis with NVivo version 12. Five themes emerged, encompassing reasons for selling tobacco, awareness, perception, compliance with tobacco sales laws, the potential economic impact of the laws, and law enforcement activities. Vendors commenced tobacco sales due to consumers' demand, profit motives, and advice from close family relatives. They were unaware and non-compliant with most of the retail-related laws. Most participants had positive perceptions about the ban on sales to and by minors, were indifferent about the ban on Tobacco Advertising Promotion and Sponsorships (TAPS) and product display, and had negative perceptions about the ban on sales of single sticks. Most vendors stated quitting tobacco sales would not have a serious economic impact on their business. In conclusion, the vendors demonstrated limited awareness and non-compliance with various retail-oriented tobacco control laws in Nigeria. Addressing these gaps requires targeted educational campaigns and effective law enforcement strategies to enhance vendors' compliance.

South Australia's tobacco retail landscape and its intersection with socioeconomic factors and smoking prevalence.

Tobacco product availability is higher in socioeconomically disadvantaged areas, which can further widen tobacco-related health and disease burden inequities. This study aimed to describe retail availability of tobacco products in South Australia and examine the association between tobacco vendor location, population's socioeconomic status (SES) and tobacco smoking prevalence. Cross-sectional 2022 tobacco vendor licence data and 2021-2022 state-wide population health survey data from the South Australian Department of Health were used. Tobacco vendors were enumerated by Statistical Area 2 (SA2) using geocoding software, with SA2s assigned health survey derived smoking prevalence, SES, remoteness category, area size, and population size. As of 2022, there were 1723 tobacco vendors in South Australia and the overall tobacco smoking prevalence across the state was 11.8%. Regression analyses indicated that tobacco vendor density increased with socioeconomic disadvantage and geographic remoteness, and that smoking prevalence was higher in low SES areas. Vendor density was not related to smoking prevalence. Findings are consistent with existing research indicating greater tobacco availability in socially disadvantaged areas. This supports that tobacco vendor saturation may be directed to areas in a way that promotes tobacco availability for vulnerable populations. Our finding that smoking prevalence was unrelated to tobacco availability contrasts existing literature and should be carefully interpreted. SO WHAT?: This is the first study to map tobacco retailers across South Australia, contributing needed evidence on the intersection of tobacco vendor density, social disadvantage, and smoking prevalence.

Environmental Factors Influencing Tobacco Usage among High School Children in Lucknow City: A Cross-sectional Study

Background: Evidence proves that the majority of adult tobacco users begin using tobacco as children or teens. Teenagers are drawn to tobacco products for a variety of reasons. Public health planners are gravely concerned about the current rapid trade and tobacco use among teenagers in a developing nation like India. Objective: The present paper focuses on the prevalence of tobacco use among children in the eighth to tenth grades and the various environmental factors that contribute to tobacco use among children. Material and Methods: Following ethical clearance, six government schools in Lucknow were chosen for this cross-sectional study, and data was gathered using the Global Youth Tobacco Survey (GYTS) to examine the relationship between tobacco use in children and other independent influencing factors. Logistic regression analysis was used. Results: 21.7% of the children used tobacco in some or the other way. Supari with tobacco was the most popular tobacco product consumed by children (48.3%). Statistical analysis showed that family members consuming tobacco at home and adults sending their kid to get tobacco had a high connection with tobacco use among children. The direct relationship between children watching individuals consuming tobacco on television and their arousal of interest for the same was also seen. Similarly, the presence of tobacco vendors outside the school and easy availability of tobacco products to children significantly influenced the tobacco consumption habit. Conclusion: Tobacco users in families, adults sending children to buy tobacco, children’s arousal of interest on seeing people using tobacco on media, tobacco vendors outside the school, and the easy availability of tobacco products have all been proven to be environmental triggering factors for tobacco consumption amongst high school students.

Signboards prohibiting tobacco sale within 100 yards of educational institutes: the appraisal of prohibition compliance and on-ground status of the anti-smoking law in New Delhi’s major administrative precinct

ABSTRACT Cigarette smoking and tobacco use pose a threat to the health of young people and adolescents. The availability of tobacco vendors near educational institutes means higher availability to a vulnerable population. The Indian Government has enacted the Cigarettes and other Tobacco products (prohibition of advertisement and regulation of trade and commerce, production, supply and distribution) Act, 2003, or the COTPA Act, 2003 under a WHO resolution, which has further rules notified. Two important rules are prohibiting the sale of tobacco products within 100 yards of educational institutes and installing a signboard stating the prohibition to sell the same. This compliance was checked in 62 educational institutions in the administrative centre of India’s capital, New Delhi. The compliance of both the points, especially something easy as installations of boards is poor and less than half of the institutions had implemented. Tobacco sellers within 100 yards were present. Beyond 100 yards, but within reach was also where tobacco sellers were present. To save young adults, the compliance of COTPA, 2003 must be made strict and offenders punished severely.

Assessment of Knowledge Gap on Cigarettes and Other Tobacco Products Act (COTPA) among Tobacco Vendors in Puducherry: A Mixed-Method Study.

Tobacco usage has been identified as a leading preventable cause of mortality and is responsible for six million fatalities per year globally. India had enacted COTPA in 2003. Tobacco vendors are one of the key stakeholders for Cigarettes and Other Tobacco Products Act (COTPA) implementation. To assess the knowledge gap on COTPA and to explore the perceived factors influencing implementation of COTPA among tobacco vendors in Puducherry. A mixed-method study was conducted among tobacco vendors from Point of Sale (PoS) around 230 educational institutions (schools and degree colleges) in Puducherry for three months. Simple random sampling was applied to select educational institutions and the tobacco vendors from PoS located around these institutions were included. Data capture was done using a pretested, face-validated questionnaire incorporated in Epicollect software 5 and data analysis by SPSSv24. Purposive sampling was employed to conduct in-depth interviews among tobacco vendors till the point of saturation and manual content analysis performed. Written informed consents were sought. Institutional Ethical Committee approval was obtained. Majority (95.7%) reported that they were aware of tobacco control legislation, but only one person had heard of COTPA. Awareness about the display of signage boards at PoS was observed in 75.7% vendors. Around 41.7% reported that they should not advertise any kind of tobacco products. Three major themes were identified: facilitators, barriers, and suggested measures for COTPA implementation. Tobacco vendors in Puducherry were aware of tobacco control legislations but not familiar with the COTPA and its provisions. It is necessary to put forth efforts to educate these important stakeholders to be more cognizant of COTPA and to effectively include them in anti-tobacco programs.

A mixed-methods evaluation of the Tobacco Retailer Advanced Compliance (TRAC) online training (e-learning) program.

Tobacco vendor training is recognized as an essential element to reduce youth access to tobacco. The TRAC training program was developed utilizing best-practices in tobacco retailer training, adult instruction, and e-learning. The objective of this mixed-methods study is to evaluate the acceptability, usability and knowledge impact of an online tobacco retailer program. An interview guide and evaluation questionnaire were used to collect data on usability and acceptability. To test learner knowledge, each module included a final set of 15 questions randomly chosen and posed to participants before and after the training. Content analysis, chi-squared tests, Student's t-tests, and paired tests were utilized for data analysis. The evaluation was conducted in Alberta, Canada in 2020. A total of 128 participants enrolled in the study. The main themes revealed in the qualitative aspect of the evaluation were: the training was easy to navigate, engaging, informative, and beneficial to the staff's daily work. Compared with the pre-training test, a significantly higher post-training test score, mean and (SD), was recorded for clerks who completed the clerk training module [59.1 (12.8) vs 75.5 (11.1), t=8.6378, p<0.001], and managers who completed the managers training module [51.5 (11.1) vs 73.1 (12.3), t=7.6446, p<0.001]. Similarly, a higher number of participants achieved the passing score of 80% in the post-training test in all three groups. The online training was found to be acceptable and effective in increasing the mean individual score in the knowledge test and in increasing the percentage of participants achieving the passing score. The TRAC training is the first known tobacco retailer training course to employ best practices in tobacco retailer training, adult instruction, and e-learning. Further evaluation of long-term outcomes on employee behavior and on overall compliance with tobacco legislation is recommended.

Compliance with Section 7 (2) of the Cigarettes and Other Tobacco Products Act (COTPA) 2003, Ban of Sale of Loose Tobacco, in Karnataka: A Cross-Sectional Study.

Banning smoking in public places has considerably reduced the number of smokers. However, the sale of loose tobacco encourages tobacco use. There is limited data on compliance with section 7(2) of the Cigarettes and Other Tobacco Products Act (COTPA), 2003, concerning the ban on loose tobacco sales in India. The aim of this study is to assess the compliance of section 7(2) of COTPA concerning the ban on loose tobacco sales in four selected cities of Karnataka. This community-based study used a cross-sectional design. Two neighboring cities, that is, district headquarter from North (Bidar and Vijayapura) and South (Mandya and Chikkamagaluru) Karnataka were considered for the study. A total of 207 vendors and 204 smokers were selected using time-cluster sampling. Data was collected using observation and interview methods. Semi-structured interview schedules were administered to smokers and vendors. Percentages and frequencies were used to describe the data. Most tobacco vendors (92%) and smokers (91%) were unaware of the loose tobacco ban. Most smokers (76%) perceive that buying cigarettes in packets would increase smoking. Most smokers (96%) prefer to buy cigarettes in loose. The sale of loose tobacco was widely prevalent (94%) in the four surveyed cities. Point of sale of loose tobacco includes tea shops (38%), petty shops (31%), pan shops (25%), and bakeries (6%). There is a high degree of noncompliance with Section 7 (2) of COTPA, 2003 regarding ban on selling loose tobacco.

Impact of ban on commercial smokeless tobacco products among users and vendors in West Bengal and Kerala states, India

IntroductionSince 2011, sale of commercially available smokeless tobacco products for chewing such as gutkha has been prohibited in many states in India. The current study attempts to understand the effectiveness and perception towards ban on gutkha sales in West Bengal and Kerala. MethodsTotal six districts from both the states (three districts from each state). From each district, 1 Municipality and 2 Community Development Blocks were selected randomly, representing each cluster. From each cluster, line transect survey was used to identify Point of Sale (POS) of tobacco products. Tobacco consumers and vendors were interviewed from POS. Results865 tobacco users (West Bengal = 450, Kerala = 415) and 173 vendors (West Bengal = 90, Kerala = 83) were interviewed for the study. 16.1% of the total users from Kerala were using gutkha alone or in combination with other tobacco chewing products while in West Bengal the corresponding figure was 17.3%. Knowledge on ban was high among the consumers (95.7%) and vendors (100%) in Kerala while in West Bengal it was 64% and 62.2% respectively. Gutkha was available in 68% of the shops in West Bengal, while in Kerala no sale was reported in shops, though half of the vendors interviewed, admitted its sales in black market. ConclusionThe ban had little impact in West Bengal in the open market, while it had moderate impact in Kerala. However, the black market sales in Kerala are a matter of concern. Strict legislative measures are essential to cut the supply route for effective implementation of the ban.

Awareness about Loose Tobacco Ban among Tobacco Users and Vendors

Background: Ban on smoking in public places reduced the number of smokers considerably. According to Global Adult Tobacco Survey-2, tobacco use is decreased by 3% in Karnataka. However, the loose sale of tobacco products encourages the practice as tobacco users continue to use tobacco by purchasing loose tobacco products. Hence, the present study was carried out to assess the compliance of loose tobacco ban in Bidar city of Karnataka. Aim: The aim of this study is to assess the compliance on loose tobacco ban in Bidar City. Methods: The exploratory research design was used. The study was cross-sectional and community based in nature. Sample Size: 98; 50 vendors and 48 consumers were randomly selected using the time-cluster sampling. Data were collected from 22 different locations using the observation and interview method within 2 km radius of Bidar City. Two separate pretested and predesigned semi-structured interview schedules were administered to tobacco users and vendors. The study was carried out in November 2019. Ethical clearance was obtained from the Institutional Ethics Committee. Statistical analysis was done using the percentages and frequency tables. Results: Majority (96%) of the tobacco users were unaware of loose tobacco ban in Karnataka and prefer to buy cigarettes in loose. Four percent of tobacco users were aware that loose tobacco is banned. Majority of (76%) tobacco users think buying a full pack of cigarettes would increase smoking. There is absolutely no compliance on loose tobacco ban by tobacco vendors.

The association of tobacco use in adolescents with their interpersonal surroundings and assessing tobacco vendor compliance with COPTA policies: A cross-sectional study

IntroductionThe prevalence of tobacco consumption is increasing globally and in South-east Asian countries. Despite the government's efforts in passing the laws for monitoring tobacco consumption, their effectiveness is questionable. The study's objectives are to investigate the association of tobacco use among the study participants as a function of community, interpersonal and individual factors. MethadologyA conceptual framework was drawn based on Bronfenbrenner's theory of the ecology of human development, the social learning theory, and the social control theory. An observational study was conducted in 13 government and 26 private pre-university colleges in the Shimoga district of Karnataka, India. The study was conducted in two stages. First at the student level and the second at the tobacco vendor level. Ethical approval from the institutional board and informed consent from the participants were obtained. A descriptive, comparative and multivariate analysis was performed. ResultsOf the 726 participants, 19.6% had used tobacco at least once. The most common type being flavoured cigarettes (54.3%). The average compliance of permanent tobacco outlets was 6.1/10, while the mobile tobacco outlet scored 3.8/10. Active tobacco use was strongly associated with peer tobacco use (r = −0.439, p < 0.001), community compliance (r = −0.365, p = 0.004), family educating against tobacco use (r = −0.269, p < 0.038) and age of initiation of tobacco use (r = −0.327, p = 0.011). ConclusionOur study shows us that the issue of adolescent tobacco use is multipronged. It centres on community, interpersonal and individual factors. We need a mixed-methods approach focusing on improving compliance with COPTA laws and effective anti-tobacco education in schools and immediate interpersonal surroundings.

Characterizing California licensure status and tobacco user experience with adverse events using Yelp data

Various tobacco vendors, including alternative tobacco product sellers, are listed on the popular crowdsourced business listing platform Yelp. Yelp is used to rate and choose tobacco, electronic nicotine delivery systems (ENDS) goods/services and includes self-reporting of user experiences with shops and products. We cross-referenced California Department of Tax and Fee Administration (CDTFA) licensed tobacco, vape, and head shop retail stores with publicly available Yelp business listings to identify licensed and unlicensed stores in California. We extracted metadata associated with store accounts and analyzed user comments and ratings for discussion of tobacco-related complaints and adverse events. We detected a total of 3,717 shops that were categorized as tobacco/vape/head shops on Yelp and by cross-referencing with CDTFA data, licensed businesses accounted for 49.5% (n = 1,841), licensed individual retailers 31.6% (n = 1,174), and suspected unlicensed storefronts 18.9% (n = 702). Businesses and individuals with a state tobacco retail license received a higher average rating from Yelp users (3.86 out of 5) compared to unlicensed shops (3.57) (p < 0.001). Additionally, 4,682 unique comments about licensed businesses, 1,535 unique comments about individual retailers, and 560 unique comments about unlicensed vendors were reviewed, with themes including discussion about defective and counterfeit products and adverse events including coughing, difficulty breathing and reports of hospitalization detected. In contrast, comments about licensed stores predominantly discussed customer service issues. Close to one-fifth of tobacco, vape and/or head shops reviewed on Yelp were not in CDTFA’s licensure database. Overall self-reported tobacco user experiences appeared to differ in content and severity based on whether an establishment was licensed. These results have the potential to identify unauthorized stores and adverse events associated with their tobacco and vaping products or services.

Compliance with national tobacco control legislation: a survey of tobacco vendors of Peshawar, Khyber Pakhtunkhwa

Introduction: Tobacco remains the world’s leading preventable cause of death, with the majority of tobacco-caused deaths occurring in low- and middle-income countries. The Government of Pakistan 2002 Prohibition of Smoking in Enclosed Places and Protection of Non-smokers Health Ordinance comprehensively prohibits all kinds of tobacco advertisement, sponsorship, and ban of selling cigarettes to minors, near the vicinity of educational institutes and to sell tobacco without a license. However, it is a common observation that tobacco vendors do not comply with the policy.&#x0D; Objective: To assess the compliance with anti-tobacco laws by tobacco vendors in the city of Peshawar, Khyber Pakhtunkhwa, Pakistan.&#x0D; Material &amp; Methods: A cross-sectional study was conducted in 145 shops across 2 jurisdictions (Hayatabad and Peshawar city) of Peshawar. The implementations of tobacco laws like advertisement, tobacco selling to minors (&lt;18 years) and tobacco selling in the vicinity of educational institutes were assessed through a self-structured questionnaire. The data were transferred and analyzed through SPSS version 22 for descriptive statistics.&#x0D; Results: The most common method of advertisement of tobacco products was stickers (33.3%) followed by dangles (29.6%) and product showcasing (15.7%). The percentage of tobacco sold to minors was 63%; 42% vendors were near the educational institutes. The selected shops were selling smokeless tobacco (82.6% shops) as well, alongside cigarettes. Unlicensed shops were 97.9% which approximately makes the whole of the sample size.&#x0D; Conclusion: The compliance of tobacco vendors in Peshawar towards tobacco law is very poor. Also, the sale of tobacco to minors was found to be a routine occurrence.

Compliance monitoring of cigarettes and other tobacco products act (COTPA) and its awareness among person responsible for compliance in Srinagar government hospitals

Background: The unsolicited tobacco exposure among non-smokers has led to an increase in burden of tobacco related diseases. The Cigarettes and Other Tobacco Products (COTPA) Act 2003 Section 4, 6 aims to reduce exposure to SHS. Tobacco-free hospital campus reduce exposure to environmental tobacco smoke. Awareness and compliance to COTPA are key to achieving its intended outcome. With this background, the present work was designed to assess the compliance and awareness among persons responsible for compliance (PRC) of Section-4 and 6 of COTPA in hospitals of Srinagar district of Jammu and Kashmir. Methods: An observational cross – sectional study was conducted within Government hospitals. A total of 10 hospitals were selected using convenient sampling. The Johns Hopkins Bloomberg School of Public Health’s observational and interview checklist was used to for data collection. These places were observed for certain parameters of assessment by a structured checklist, which included evidence of active smoking, evidence of recent smoking, display of signages, presence of smoking aids, cigarette butts and bidi ends. Results: The signs of active smoking were observed more in residential areas (66.7%). No smoking signages” board was displayed in 86% of the hospitals but compliance to content was found only 30%. Tobacco vendors were present in 80% in places around hospital buildings. 90% of persons responsible for compliance were aware of the existence of the COTPA law in public places. However, only (30%) knew that the provisions included a penalty for those who violated the provisions of the law. Conclusions: Low compliance, coupled with the lack of appropriate awareness among PRCs about COTPA, demands a comprehensive strategy to enhance awareness and strict enforcement of the law.

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

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

Knowledge, Attitude, and Practices of Tobacco Vendors toward Selling Tobacco Products to Young Children and Adolescents in Central Delhi.

BackgroundTobacco consumption by youth is a serious public health problem. Regulation on tobacco sales has been given enough attention in our country, but very less information exists about the knowledge and attitude regarding tobacco laws by tobacco vendors.Aim and objectiveTo study the knowledge, attitude, and practices of tobacco vendors regarding the selling of tobacco to children and adolescents up to 18 years of age in the Central Delhi area.Materials and methodsA total sample size of 60 tobacco vendors was selected by random sampling method. The procedure and objectives of the study were explained to them and written informed consent was obtained. A casual interview of the tobacco vendor was taken and answers given by them were recorded using a questionnaire. After completing the data, statistical analysis was performed.ResultsThe mean age of children and adolescents visiting tobacco shops was 11.83 years and the minimum age was 8 years. It was reported that 19 (31.7%) vendors always asked the age of the child while none of them asked for proof of age. Forty-two (70%) of them reported these children and adolescents visit their shop alone while 18 (30%) reported that they visit with friends. Khaini was the commonest form of tobacco bought/consumed by children and adolescents. Twenty-seven (45%) vendors reported that these children consume tobacco publically.ConclusionDespite knowing various anti-tobacco laws, tobacco vendors are selling harmful tobacco products to children and adolescents.How to cite this articleVerma AR, Goswami M. Knowledge, Attitude, and Practices of Tobacco Vendors toward Selling Tobacco Products to Young Children and Adolescents in Central Delhi. Int J Clin Pediatr Dent 2021;14(1):97–99.

Tobacco retailer density and tobacco retailers near schools in two cities of East India, Ranchi and Siliguri

BackgroundPassive and active exposure to tobacco smoke is associated with tuberculosis infection and tuberculosis disease. Addressing tobacco use is a critical strategy to address tuberculosis (TB). Studies conducted globally demonstrate that the physical presence and density of tobacco vendors can increase tobacco use in both youth and adults. Little is known about the number and density of tobacco vendors in India, where there are approximately 267 million tobacco users. In India, a national tobacco control law (COTPA, 2003) prohibits the sale of tobacco within 100-yards of an educational institution. Little is known about the number of tobacco vendors operating within 100-yards of schools. This study assesses the number and density of tobacco vendors in the cities of Ranchi (Jharkhand) and Siliguri (West Bengal), and the number of retailers selling tobacco near schools. Both of these jurisdictions have passed local tobacco vendor licensing laws. MethodsData collectors conducted a census of tobacco vendors within select wards in each city. Each tobacco vendor was classified as either an independent store, permanent kiosk, temporary kiosk, or street vendor. The location of each tobacco vendor was recorded. Data collectors also noted the location of any school/educational institution. Spatial analysis was conducted using GIS software (QGIS 10.5). 100-yard buffers were mapped around school premises. Tobacco vendor density was calculated by area, by road distance, and by population. Tobacco vendors within 100-yards of school properties were counted. ResultsThe study identified 559 tobacco vendors in Ranchi, across three wards, and 367 tobacco vendors in Siliguri, across five wards. When considering the three wards in Ranchi, tobacco vendor density was 68 vendors/km2, 06 vendors/km road, and 08 vendors/1000 population. In Siliguri, the tobacco vendor density was 99 vendors/km2, 05 vendors/km road, and 07 vendors/1000 population. The study found that 19% (n = 105) of vendors observed in Ranchi and 23% (n = 84) of vendors in Siliguri were located within 100-yards of one or more schools. The most common vendor-type in Ranchi was an independent store (58%) and in Siliguri was a permanent kiosk (52%). ConclusionTobacco vendor density was remarkably high in each of the surveyed wards. The study identified tobacco vendors operating within 100-yards of schools. Fully implementing COTPA, 2003 could reduce vendor density in Ranchi and Siliguri. Each city's tobacco vendor licensing laws could further reduce tobacco vendor density. Other strategies should be considered to further reduce density, including setting limits on tobacco vendor type, area or population. The data from this study can be used to inform future tobacco control strategies for these cities and others in the region.

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.