BMJ 2014;348:g3562 doi: 10.1136/bmj.g3562 (Published 28 May 2014)
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NEWS Tobacco control policies in South Asia are not tough enough on smokeless tobacco Sanjeet Bagcchi Kolkata
Tobacco control policies in India, Bangladesh, Nepal, and Pakistan, either do not deal with smokeless tobacco use adequately or the policies are poorly implemented, a study published in Nicotine and Tobacco Research has found.1
The researchers looked at whether smokeless tobacco featured in the existing tobacco control policies of the four south Asian countries, to what extent the policies were implemented and what were the barriers to implementation. They conducted 11 interviews with representatives of central government responsible for tobacco control and representatives of civil society organisations advocating strong tobacco control policies, and their findings showed that “taxes were low and easily evaded; regulatory mechanisms, such as licensing and trading standards, either did not exist or were inadequately enforced to regulate the composition and sales of such products; and there was little or no cessation support for those who wanted to quit.”
Where legislation on smokeless tobacco existed, regulation remained weak because of inadequate training of law enforcers, unclear roles and responsibilities of different government departments, and inadequate resources for enforcement. Weak administration of taxes on tobacco products was also common. “Sale of smokeless tobacco products in informal establishments, often in unpacked forms, compounds this problem,” the researchers said. Lack of political will to provide or enhance coverage of cessation services was a major barrier hindering reduction of smokeless tobacco consumption, the researchers noted. Smokeless tobacco had a high social acceptance and there was little understanding about its supply chain. Almost a fifth of the world’s tobacco is consumed in smokeless form, and the practice is particularly common in south Asia.
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Existing legislation often referred to “smoking” rather than “tobacco” they found, and an illicit trade in smokeless tobacco between India and its neighbouring countries also made tackling it difficult.
The researchers also found that smokeless tobacco use is generally not captured in medical records; no systematic information gathering is done on smokeless tobacco’s production, sales, and revenue collection; and departments, such as the national statistics bureaus, customs and revenue, and trade and commerce, do not liaise and share information. Sarwat Shah, one of the authors and a research fellow at the University of York, UK, told The BMJ that the study had several key messages, “For the scientific community, [it is] to explore the gaps in knowledge and policy. For governments and key stakeholders, [it is] to amend tobacco related policies and incorporate legislation around the smokeless tobacco supply chain,” she said.
Rajeev Cherukupalli, an assistant scientist at the Johns Hopkins University in Baltimore in the US, said, “Smokeless tobacco products in south Asia are both pervasive (over a quarter of adults in India and Bangladesh, for example, are current users) and highly diverse. Governments need to commit themselves to protect their citizens from the harms of these products through stronger regulation of their production, sale and marketing.” 1
Khan A, Huque R, Shah SK, Kaur J, Baral S, Gupta PC, et al. Smokeless tobacco control policies in south Asia: a gap analysis and recommendations. Nicotine Tobacco Res 2014;16:890-4.
Cite this as: BMJ 2014;348:g3562 © BMJ Publishing Group Ltd 2014
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS Tobacco control policies in South Asia are not tough enough on smokeless tobacco Sanjeet Bagcchi Kolkata
Tobacco control policies in India, Bangladesh, Nepal, and Pakistan, either do not deal with smokeless tobacco use adequately or the policies are poorly implemented, a study published in Nicotine and Tobacco Research has found.1
The researchers looked at whether smokeless tobacco featured in the existing tobacco control policies of the four south Asian countries, to what extent the policies were implemented and what were the barriers to implementation. They conducted 11 interviews with representatives of central government responsible for tobacco control and representatives of civil society organisations advocating strong tobacco control policies, and their findings showed that “taxes were low and easily evaded; regulatory mechanisms, such as licensing and trading standards, either did not exist or were inadequately enforced to regulate the composition and sales of such products; and there was little or no cessation support for those who wanted to quit.”
Where legislation on smokeless tobacco existed, regulation remained weak because of inadequate training of law enforcers, unclear roles and responsibilities of different government departments, and inadequate resources for enforcement. Weak administration of taxes on tobacco products was also common. “Sale of smokeless tobacco products in informal establishments, often in unpacked forms, compounds this problem,” the researchers said. Lack of political will to provide or enhance coverage of cessation services was a major barrier hindering reduction of smokeless tobacco consumption, the researchers noted. Smokeless tobacco had a high social acceptance and there was little understanding about its supply chain. Almost a fifth of the world’s tobacco is consumed in smokeless form, and the practice is particularly common in south Asia.
For personal use only: See rights and reprints http://www.bmj.com/permissions
Existing legislation often referred to “smoking” rather than “tobacco” they found, and an illicit trade in smokeless tobacco between India and its neighbouring countries also made tackling it difficult.
The researchers also found that smokeless tobacco use is generally not captured in medical records; no systematic information gathering is done on smokeless tobacco’s production, sales, and revenue collection; and departments, such as the national statistics bureaus, customs and revenue, and trade and commerce, do not liaise and share information. Sarwat Shah, one of the authors and a research fellow at the University of York, UK, told The BMJ that the study had several key messages, “For the scientific community, [it is] to explore the gaps in knowledge and policy. For governments and key stakeholders, [it is] to amend tobacco related policies and incorporate legislation around the smokeless tobacco supply chain,” she said.
Rajeev Cherukupalli, an assistant scientist at the Johns Hopkins University in Baltimore in the US, said, “Smokeless tobacco products in south Asia are both pervasive (over a quarter of adults in India and Bangladesh, for example, are current users) and highly diverse. Governments need to commit themselves to protect their citizens from the harms of these products through stronger regulation of their production, sale and marketing.” 1
Khan A, Huque R, Shah SK, Kaur J, Baral S, Gupta PC, et al. Smokeless tobacco control policies in south Asia: a gap analysis and recommendations. Nicotine Tobacco Res 2014;16:890-4.
Cite this as: BMJ 2014;348:g3562 © BMJ Publishing Group Ltd 2014
Subscribe: http://www.bmj.com/subscribe
