Tobacco packaging in India: assessing compliance with Health Warning Label (HWL) laws and marketing appeals for cigarettes, bidis and smokeless products
Background: Over 100 million Indian adults use tobacco. India enhanced tobacco
warning label requirements as of 2016; a HWL should now cover 85% of the 2
principal displays. Smokers make up a smaller proportion of Indian tobacco
users; smokeless users tend to be less educated and live in more rural areas. We
assess HWL compliance and product appeals conveyed on packs of cigarettes,
bidis and various forms of smokeless tobacco.
Methods: We purchased tobacco products (cigarettes, bidis and
smokeless) according to a systematic protocol in four cities (New Delhi,
Mumbai, Chennai and Bangalore) during November-December 2016. Within each city,
we constructed a purposive sample of 12 diverse neighborhoods and data
collectors followed a walking protocol to select sales outlets, from which they
purchased one of each unique pack (all products). Two independent coders assessed
each pack using product and country specific HWL law codebooks, and a
standardized codebook for product appeals.
Results: We collected 226 unique packs; 94 cigarettes, 47 bidis and 85
smokeless. For cigarettes, 59% (N=55) had a current HWL; of these, 53% (n=29) were
compliant with size, placement and warning label components. For bidis, 91%
(N=43) displayed the current HWL, but none were compliant with all aspects of
the law. For smokeless products, 85 packs were collected of which 64% (n=54) displayed
the correct HWL, but only 1 was compliant by our indicators. We discuss challenges
in assessing HWL compliance for non-cigarette products and compare marketing
appeals between products, including cultural and religious symbolism, and depiction
of individual manufacturers.
Conclusions: India has a progressive health warning label law, but compliant
implementation differs between tobacco products. Our discussion of HWL
compliance and appeals on packs suggest areas for attention to ensure that
India continues to see rates of tobacco use decline and protect all Indians
from harm from all forms of tobacco.
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A pilot study to assess compliance and impact of health
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Karnataka State, India Somya Mullapudi, John Britton, Muralidhar Kulkarni, Crawford Moodie, Veena Kamath, Asha Kamath Tobacco Induced Diseases
Non-compliant packaging and illicit smokeless tobacco in Bangladesh, India and Pakistan: findings of a pack analysis S Abdullah, Rumana Huque, Kamran Siddiqi, Mona Kanaan, Samina Huque, Safat Ullah, Suneela Garg, Mongjam Singh, Chetana Deshmukh, Amod Borle, Romaina Iqbal, Laraib Mazhar, Mark Parascandola, Ravi Mehrotra, Ray Croucher, Zohaib Khan Tobacco Control
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