BACKGROUND: India’s tobacco control efforts, driven by the Framework Convention on Tobacco Control (FCTC) and the Cigarettes and Other Tobacco Product Act (COTPA) of 2003, face significant enforcement challenges. Despite efforts, loopholes exploited by tobacco industries have resulted in the widespread sale of non-regulated and banned products. This study examines the economic dynamics of tobacco sales at Pan kiosks in Central India, investigating the role of illicit tobacco products and offering innovative solutions to curb this growing issue.
METHODS: A mixed-methods approach was employed. Surveys were conducted across 1690 Pan kiosks categorized into three income groups: low-income (< ₹20,000/month), middle-income (₹20,000–₹50,000/month), and high-income (> ₹50,000/month). Data collected included types of tobacco products sold and profit margins. In-depth interviews with kiosk owners explored sales practices. Statistical analysis, including chi-square tests, was used to assess the relationship between shop categories and sales patterns of illicit products.
RESULTS: The results revealed that 95% of kiosks sold non-regulated tobacco products. High-income kiosks, accounting for 30% of the sample, derived 60% of their profits from hookahs, alternative tobacco products and banned products like e-cigarettes. Middle-income kiosks (30% of the sample) earned 45% of their profits from selling single cigarettes without health warnings, which is in violation of regulations. Low-income kiosks (40% of the sample) generated 55% of their revenue from selling kharra, and gutkka a banned product in Central India.
CONCLUSIONS: The widespread sale of non-regulated and banned products presents a severe threat to public health and undermines tobacco control efforts. Immediate actions, such as implementing blockchain technology for tracking sales and incentivising vendors to transition to legal products, are critical to curbing this illegal market. These regulatory innovations be prioritised to safeguard public health and mitigate the economic impact of the illicit tobacco trade, as the situation has reached a tipping point that demands prompt intervention.