Background and challenges to implementation:
The Indian tobacco control law (COTPA) prohibits tobacco advertising, promotion and sponsorship. However, emerging products like e-cigarettes and e-hookahs (ENDS) remain unregulated and traditional hookahs are regulated inadequately. Rampant promotional propaganda for these products has created a general mis-perception that they are safe/less harmful than regular tobacco products, resulting in increasing popularity among adolescents and youth.

Intervention or response:
A youth-led monitoring exercise was conducted to build their capacity for identifying mis-leading and false ENDS and hookah advertisements and promotional campaigns, at multiple Points of Sale (PoS), at New Delhi, India.
Sensitisation sessions were conducted for 104 school and college students, (13-23 years) from 6 schools and 5 colleges, on the hazards of ENDS and hookah usage; deceptive strategies of the tobacco industry to take advantage of policy loopholes. These empowered youth monitored 79 PoS (64 physical and 15 e-commerce sites), using standardised monitoring protocols/tools.

Results and lessons learnt:
Approximately 31% of physical sites were within 100 yards of an educational institution (prohibited under COTPA). Warning boards against sale to minors were missing in more than half of the PoS. ENDS were commonly being promoted as: safe, herbal, as cessation devices and also as 'trendy' tobacco products. At 47% of PoS, hookah flavours were arranged as power walls. A range of e-commerce sites were selling ENDS and hookahs, without asking for any age proof or only self-declaration of age, which can be mis-reported. These websites offered attractive discounts and 'free home delivery' to boost sale.


[Youth led monitoring_Key Findings]



Conclusions and key recommendations:
Youth-targeted promotion and sale of ENDS and hookah is rampant. E-commerce sites are particularly lucrative PoS. The youth had many false notions about ENDS and hookah. There is an urgent need to regulate these products through national and global policy measures, in order to prevent the tobacco industry from exploiting this grey area in tobacco control policy.