Smokeless tobacco products, supply chain and retailers' practices in England: a multimethods study to inform policy

TY - JOUR

T1 - Smokeless tobacco products, supply chain and retailers' practices in England

T2 - a multimethods study to inform policy

AU - Siddiqui, Faraz

AU - Khan, Talib

AU - Readshaw, Anne

AU - Croucher, Ray

AU - Dockrell, Martin

AU - Jackson, Cath

AU - Kanaan, Mona

AU - Mccambridge, Jim

AU - Mcneill, Ann

AU - Parrott, Steve

AU - Sheikh, Aziz

AU - Siddiqi, Kamran

N1 - © 2021 Author(s) (or their employer(s)). This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.

PY - 2021/11/16

Y1 - 2021/11/16

N2 - Background: In England, many people of South Asian origin consume smokeless tobacco (ST). ST use can lead to oral cancer, which is disproportionately high in South Asians. Our aims were to assess the compliance of ST product retailers with statutory regulations and to explore the supply chain of ST. Methods: We undertook a multimethods study between August 2017 and July 2019 in five English boroughs with a high proportion of ethnic South Asians. We purchased ST products and conducted field surveys with ST retailers at point of sale. Qualitative interviews were conducted with ST retailers and suppliers. ST packs were assessed for regulatory compliance, while quantitative and qualitative data triangulated information on retailers' practices and the ST supply chain. Results: We collected 41 unique ST products, which included dry snuff, naswar, gutka, chewing tobacco and zarda. ST products were not registered, and demonstrated low compliance with health warning (14.6%) and packaging (56.1%) requirements. ST availability in surveyed boroughs was high (38.2%-69.7%); dry snuff, naswar and zarda were most commonly available. ST retailers demonstrated limited knowledge of regulations, and one-third were found to advertise ST at point of sale. Qualitative insights revealed illicit supply and distribution networks, as well as ST production in discreet locations. Conclusion: ST products are widely available in England, yet non-compliant with statutory regulations. In order to safeguard consumers, in particular ethnic South Asians, stronger efforts are needed to regulate the supply chain of ST at both national and international levels.

AB - Background: In England, many people of South Asian origin consume smokeless tobacco (ST). ST use can lead to oral cancer, which is disproportionately high in South Asians. Our aims were to assess the compliance of ST product retailers with statutory regulations and to explore the supply chain of ST. Methods: We undertook a multimethods study between August 2017 and July 2019 in five English boroughs with a high proportion of ethnic South Asians. We purchased ST products and conducted field surveys with ST retailers at point of sale. Qualitative interviews were conducted with ST retailers and suppliers. ST packs were assessed for regulatory compliance, while quantitative and qualitative data triangulated information on retailers' practices and the ST supply chain. Results: We collected 41 unique ST products, which included dry snuff, naswar, gutka, chewing tobacco and zarda. ST products were not registered, and demonstrated low compliance with health warning (14.6%) and packaging (56.1%) requirements. ST availability in surveyed boroughs was high (38.2%-69.7%); dry snuff, naswar and zarda were most commonly available. ST retailers demonstrated limited knowledge of regulations, and one-third were found to advertise ST at point of sale. Qualitative insights revealed illicit supply and distribution networks, as well as ST production in discreet locations. Conclusion: ST products are widely available in England, yet non-compliant with statutory regulations. In order to safeguard consumers, in particular ethnic South Asians, stronger efforts are needed to regulate the supply chain of ST at both national and international levels.

KW - advertising and promotion

KW - disparities

KW - non-cigarette tobacco products

KW - surveillance and monitoring

UR - http://www.scopus.com/inward/record.url?scp=85099063861&partnerID=8YFLogxK

U2 - 10.1136/tobaccocontrol-2020-055830

DO - 10.1136/tobaccocontrol-2020-055830

M3 - Article

C2 - 33414267

AN - SCOPUS:85099063861

SN - 0964-4563

VL - 30

JO - Tobacco Control

JF - Tobacco Control

M1 - e45-e49

ER -