Abstract
Introduction Illicit smokeless tobacco (ST) trade has seldom been documented despite ST use in at least 127 countries across the world. Based on non-compliance with packaging regulations, we report the proportion of illicit ST products from samples on sale in Bangladesh, India and Pakistan where 85% of global ST users reside. Methods We purchased unique ST products from tobacco sellers in two purposively selected administrative areas (division/district) in each of the three countries. The criteria to determine illicit ST products were based on country-specific legal requirements for ST packaging and labelling. These requirements included:’market retail price disclosure’,’sale statement disclosure’,’pictorial health warning (PHW) pertinence’,’appropriate textual health warning’ and’using misleading descriptors (MDs)’. Non-compliance with even one of the legal requirements was considered to render the ST product illicit. Results Almost all ST products bought in Bangladesh and India were non-compliant with the local packaging requirements and hence potentially illicit, all products in Pakistan lacked desirable features. The most common feature missing was health warnings: 84% packs in Bangladesh, 93% in India, and 100% in Pakistan either did not have PHW or their sizes were too small. In Bangladesh, 61% packs carried MDs. In India and Pakistan, the proportions of such packs were 32% and 42%, respectively. Conclusions Weak and poorly enforced ST control policies may be slowing the progress of tobacco control in South Asia. Standardised regulations are required for packaging and labelling ST. Improving compliance and reducing sale of cheap illicit products may require business licensing and market surveillance.
| Original language | English |
|---|---|
| Pages (from-to) | 333-340 |
| Number of pages | 8 |
| Journal | Tobacco Control |
| Volume | 33 |
| Issue number | 3 |
| Early online date | 27 Sept 2022 |
| DOIs | |
| Publication status | Published - 19 Apr 2024 |
Bibliographical note
Funding Information:This research is funded by the UK’s National Institute for Health Research (NIHR) (ASTRA (grant reference number 17/63/76)).
Funding Information:
Authors would like to express sincere gratitude to the University of Dhaka for funding SMA to pursue his PhD at the University of York, UK through 'Bangabandhu Overseas Scholarship Program 2021–2022'. The team acknowledges the contributions of the anonymous reviewers throughout the process which certainly improved the rationality and readability of the paper. Most importantly, appreciation for the field supervisors, enumerators and the data management team in all study countries whose support made this study a successful implementation.
Publisher Copyright:
© Author(s) (or their employer(s)) 2024.