BACKGROUND: Bangladesh has a complex tobacco consumption pattern with varieties of tobacco products and intricate packaging designs aimed at attracting consumers. Graphic Health Warnings (GHW) serve as a cost-effective module for discouraging tobacco consumption. Since 2016, Bangladesh has implemented 50% GHW on tobacco packaging. This study evaluates the GHW implementations’ status in eight divisional cities and identifies the associated challenges.
METHODS: The study was conducted from November 2023 to April 2024 in eight divisional cities, utilizing both qualitative and quantitative techniques. Data were collected through semi-structured questionnaires and observational checklists on Section 10 of the tobacco control law by using Kobo Toolbox. Four retail and four wholesale shops were systematically selected in each city as intervention sites, and 272 tobacco products of available categories, including local and national brands, were observed.
RESULTS: The survey found that 85% of tobacco packaging across all categories displayed GHWs. Specifically, the GHW was observed on 89% cigarettes, 63% bidis, 88% Zarda, and 55% Gul packs. Compliance of minimum 50% coverage on cigarettes, bidis, Zarda, and Gul packets was 92%, 40%, 18%, and 8%, respectively. Moreover, GHWs displayed on both sides: 100% for cigarettes, 40% for bidis, 13% for Zarda, and 42% for Gul. Adherence to the three-month rotation of the image varied significantly, ranging from as low as 20% for bidis to as high as 67% for Gul. Compliance with key legal requirements was particularly low among non-cigarette products. The variability in size and form of smokeless tobacco (SLT) products and bidi packets, compounded by the lack of manufacturing dates, presents substantial challenges in comprehensively assessing GHW implementation across these categories.
CONCLUSIONS: Standardized packaging for smokeless tobacco and bidi, along with manufacturing dates, is essential to ensure the efficacy of the GWH provisions. Effective and regular monitoring mechanisms are required to ensure compliance with GHW provisions in Bangladesh.