scholarly journals What is India's Position in Implementing the WHO Framework Convention on Tobacco Control? A Policy Analysis of the Tobacco Control Law and National Tobacco Control Program

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 235s-235s
Author(s):  
S. Ghose ◽  
S.S. Datta

Background and context: The Framework Convention on Tobacco Control (FCTC) is the world's first public health treaty enacted under the World Health Organization (WHO). It is the biggest global initiative in tobacco control. India is a signatory to this treaty since 2004. India is home to 275 million tobacco users and is the second largest producer and user of tobacco products after China. The country is also known for widespread production and consumption of many smokeless forms of tobacco. India's progress in complying with the Framework Convention treaty had been inconsistent. While few states (provinces) are making significant progress, larger parts of the country struggles with gaps in the law, weak regulatory surveillance and overall noncompliance. The protobacco lobbies in India argue against the legislation by forecasting that banning tobacco production would lead to huge loss of employment and significant negative impact on the economy. These issues act as big deterrents to the country's tobacco control initiatives. Aim: There are very few published policy analyses on compliance with the FCTC treaty and identifying gaps in Indian tobacco control laws. This paper looks at India's tobacco use behavior, the national tobacco control laws, and its gaps and barriers. Strategy/Tactics: Using a policy triangle framework developed by Walt and Gilson (1994), it analyzes the national tobacco control policies and laws against the current scenario to identify areas of improvement and policy reform. Program/Policy process: The Indian tobacco control regulations and the National Tobacco Control Plan is evaluated in light of the WHO FCTC treaty to identify gaps and barriers to its implementation using published evidence. Outcomes: The analysis revels significant gaps and legal complexities that are currently being exploited by the tobacco industry as they continue to promote tobacco products and increase production capacity. There are also important ethical issues related to the use of child labor in tobacco trade in India. What was learned: This paper recommends to amend the Indian tobacco control law to address the gaps and implement a more stringent legislation commensurate to the tobacco use patterns and existing barriers. This also recognizes the political-economic aspects and reflects on the contextual variables and stakeholders that play a significant role in deciding the fate of tobacco production, use and control in India.

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 198s-198s
Author(s):  
S. Ghose ◽  
S.S. Datta

Background: Tobacco is the single largest cause of preventable death globally. An emerging body of evidence shows that tobacco is 1 of the identified causes of cancer contributing to 50% of cancers in men and 20% in women and the same is estimated to kill 10 million people by 2030. The epicenter of this epidemic is the low and middle income countries with 80% of the 1 billion smokers in the world coming from there. India is home to 275 million tobacco users and is the second largest producer and user of tobacco products after China. Many of the users demonstrate a very early smoking debut and a significant proportion of India's population falls in this group. Prevention of early tobacco debut and use of tobacco in youth is 1 of the critical ways of reducing the burden of noncommunicable diseases in the world. There is very limited information on how today's youth perceive using tobacco products, and what they think of the anti-tobacco campaigns and legislative measures. Aim: The qualitative arm aims to bridge some of the knowledge gaps related to tobacco use in today's urban youth; to understand the perceptions of the youth about tobacco. The policy piece evaluates relevant tobacco control legislations in India using a prevalidated policy analysis framework. It critically analyses the gaps of the national tobacco control mechanisms responsible for impacting the tobacco use in the youth. Methods: A qualitative grounded theory approach was followed. In a university in India, 30 young undergraduate students were recruited. Data were collected through in-depth interviews, focus groups and participant observations. The policy section critically analyzed relevant parts of the India's tobacco control law taking its lead from the qualitative data, compared it with the WHO Framework Convention of Tobacco Control (FCTC), and identifies barriers and gaps to understand how its impacting the use of tobacco in youth. Results: Peer influence and social desirability emerged as major influencers for tobacco debut. Stress, exams, depression, family problems and symptoms of stress for example headache, sleeplessness etc. were other influencers for debut. The other major theme was the perceptions and concepts on tobacco addiction and quitting. Knowledge among youth on available quitting or cessation support was very little. Most of the study participants believed that the current tobacco control measures are not effective. The policy analysis of national tobacco control measures revealed significant gaps that are currently being exploited by the tobacco industry as they continue to promote tobacco products and increase production capacity. Conclusion: This study recommends amending the Indian tobacco control law to address the gaps and implement a more stringent legislation commensurate to the tobacco use patterns and existing barriers.


2021 ◽  
Author(s):  
Heeje Lee ◽  
Minah Kang ◽  
Sangchul Yoon ◽  
Kee B. Park

Abstract Tobacco use is one of the main public health concerns as it causes multiple diseases. The Democratic People’s Republic of Korea (DPRK) is one of the 168 signatory countries of the World Health Organization (WHO) member states agreed to adopt the WHO Framework Convention of Tobacco Control (FCTC). However, there is lack of information regarding the tobacco use in the DPRK and the government’s efforts for tobacco control. The aim of the study was to find the prevalence of tobacco use among the DPRK people and the government’s efforts to control tobacco use among its population, through literature review combined with online media content analysis. In 2020, the prevalence of tobacco smoking in males of 15 years and older was 46.1%, whereas that in females was zero. The online media contents showed the DPRK government’s stewardship to promote population health by controlling tobacco use. Furthermore, the DPRK government has taken steps to implement the mandates of the FCTC including introduction of new laws, promotion of research, development of cessation aids, as well as public health campaigns.


2021 ◽  
Vol 14 ◽  
pp. 1179173X2110642
Author(s):  
Christopher M. Seitz ◽  
Kenneth D. Ward ◽  
Zubair Kabir

Background The World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) Health Warnings Database is an online, publicly available resource created for countries to upload and share pictorial health warnings for tobacco packaging. The purpose of this study was to evaluate the extent to which the database is used by countries for the sharing of pictorial warnings. Methods The study’s sample included parties to the FCTC who required graphic health warning labels on cigarette packaging from. Those countries were categorized as having a low, middle, and high Socio-Demographic Index (SDI). The Health Warnings Database was then analyzed for those countries’ unique pictorial images, as well as the number of pictorials that were shared between countries. Results Of the 110 countries that required pictorial warnings on cigarette packaging, only 53 (48%) voluntarily contributed pictorials to the database, with most of those (53%) being high SDI-level countries. There were 342 unique pictorials on the database, with 62 images posted by seven countries that were used by 13 other countries. Conclusion While sharing was evident from the database, there remains a need for more countries to upload the pictorials to the database. There is also a need to expand the database to include alternative tobacco products, such as waterpipe tobacco and e-cigarettes.


Author(s):  
Dhwanit Thakore ◽  
Mahesh Chavda ◽  
Girish Parmar ◽  
Tejal Sheth

Tobacco use- a major public health issue in India has an enormous effect on the lower SES population. . There is an evident link between tobacco use or consumption and poverty. The widespread use of almost all forms of tobacco among the Indian population can be attributed to the social and cultural acceptance in the country. Cigarette and Other Tobacco Products Act, 2003 (COTPA) is the legislation that regulates tobacco in India. The prime objective of this review is to compile the literature with information about the laws regulating tobacco use and the status of implementation of tobacco control provisions covered under COTPA. Since effective tobacco control measures involve multi-stakeholders i.e public health, law, trade and commerce, industry, consumer, human rights and child development, coordinated efforts are required to successful enforcement. The outcome of the current literature is bridging the gaps to make the tobacco control a very important public health goal and thereby protect the population from the consequent morbidity and mortality due to tobacco use.


2020 ◽  
Vol 22 (12) ◽  
pp. 2196-2202 ◽  
Author(s):  
Prashant Kumar Singh ◽  
Amit Yadav ◽  
Pranay Lal ◽  
Dhirendra N Sinha ◽  
Prakash C Gupta ◽  
...  

Abstract Introduction The dual use of smoked and smokeless tobacco (SLT) poses a serious challenge to tobacco control efforts. This article examines the trends and patterns of this usage in India during the period 2009–2010 and 2016–2017. Methods Data from two rounds of nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009–2010 and 2016–2017 have been used. Dual use was assessed based on current smokers and SLT users in both rounds. Results Findings reveal that dual use in India has dropped from 5.3% during 2009–2010 to 3.4% during 2016–2017, a decline of nearly 10 million dual users. However, some states have added nearly 4.6 million new dual users during this period. While dual use continues to remain high in rural areas, there has been a manifold increase in urban areas. Findings revealed that intention to quit tobacco was lower among dual tobacco users as compared to single users with considerable difference between urban and rural areas. Conclusion Easy availability and affordability of SLT products compared to smoking products and restrictions on smoking in public places may have pushed current smokers and dual users to take to or intensify their SLT consumption. Measures relating to awareness, pricing, taxation, and enforcement of tobacco control laws should focus on all forms of tobacco, especially targeting high dual burden in rural and urban settings. Implications Dual form of tobacco users represent 12% of all tobacco users in the country. The study reveals that intention to quit tobacco among dual users is significantly lower than that among single tobacco product users. This requires improving public awareness about the morbidity and mortality that arises from the use of all forms of tobacco products. Efforts to restrict the availability of tobacco products should focus on licensing the sale of all tobacco products. Reduction in dual tobacco use will not only result in multiplied health benefits but also help in achieving the Non-Communicable Diseases targets under the United Nations Sustainable Development Goals.


2019 ◽  
Vol 29 (1) ◽  
pp. 119-121 ◽  
Author(s):  
Muralidhar M Kulkarni ◽  
Veena Ganesh Kamath ◽  
Jo Cranwell ◽  
John Britton ◽  
Gaurang P Nazar ◽  
...  

BackgroundExposure to smoking in films causes smoking uptake among adolescents. Investigation of the extent to which tobacco imagery appears, or tobacco control laws are complied with in Indian films is limited, and especially so for films in regional languages. This study presents an analysis of tobacco content and compliance with tobacco control laws in popular films in several languages from the Karnataka state of India.MethodsWe used 5 min interval coding to measure actual tobacco use, implied tobacco use, tobacco paraphernalia and tobacco branding in the top 10 films identified from national box office ratings and regional distributor reports in Karnataka in 2015 and 2016. We also assessed compliance with tobacco-free film rules in India.FindingsA total of 47 films, in English, Hindi, Malayalam, Tamil, Telugu and Tulu languages were coded. Any tobacco imagery was observed in 72% of films, and actual tobacco use in 50%. Tobacco imagery was equally prevalent in films classified as suitable for universal viewing (U category) or at age 12 or more (U/A category) films; and significantly more common in films made in regional than national language (Hindi). None of the films were fully compliant with legal requirements on health spots, audiovisual disclaimers and health warnings.ConclusionsTobacco content was common in films classified as suitable for viewing by children, more among regional than national languages. Compliance with tobacco control laws was low. Stricter enforcement of tobacco-free film rules will protect children and adolescents from exposure to tobacco use on screen.


2018 ◽  
Vol 49 (2) ◽  
pp. 199-205
Author(s):  
Catherine O Egbe ◽  
Charles DH Parry ◽  
Bronwyn Myers

Tobacco use is the single largest preventable cause of death globally. For years, the tobacco industry sought to create a tobacco product that is less controversial than conventional cigarettes. Electronic cigarettes were created out of the supposed need to supply consumers of tobacco products with a less harmful tobacco product. The question remains, is it really less harmful for consumers of traditional cigarettes and other tobacco products to switch to electronic cigarettes? This article takes a closer look at the overall harm in relation to benefits of using electronic cigarettes for the individual and public health and the unintended negative consequences the introduction of electronic cigarette has had on overall public health. Given the evidence that the use of electronic cigarettes is a gateway to the use of other tobacco products especially among adolescents, we view electronic cigarettes as having the potential to cause a rebound of the tobacco use glut which the global public health community has been succeeding in reversing. We therefore support the World Health Organization’s suggestion that electronic cigarettes should be regulated as other tobacco products since there is, as yet, no harmless tobacco product. In the same vein, we view the new Tobacco Products and Electronic Delivery Systems Bill seeking to regulate electronic cigarettes in South Africa as other tobacco products as a step in the right direction.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 134s-134s
Author(s):  
M. Coutinho Marques de Pinho ◽  
C. Abreu Perez ◽  
C. Galhardo Ferreira Vianna

Background and context: In April 2017, National Agency for Health Surveillance (Anvisa) launched a public consultation for the revision of Resolution Number 335/2003, on health warning labels. Aim: A group of representatives from civil society and tobacco control advocates in Brazil met in person and virtually to make contributions to the Anvisa´s proposal for new health warning label for tobacco products packages, considering the civil rights for participation and collaboration to Brazilian policies provided by public consultation. Strategy/Tactics: The advocates and researches consulted the Framework Convention on Tobacco Control of the World Health Organization and its Guideline for Article 11 (Packaging and Labeling of Tobacco Products) implementation adopted in 2008 based on scientific studies and successful experiences in other countries. In addition, international researchers and representatives of international institutions were also consulted to collect successful examples of health warnings in the world. Program/Policy process: In October 2017, the Anvisa Board of Directors at a public ordinary meeting approved the new health warnings and in December of the same year, published the new resolution about it. Outcomes: In a comparative analysis, even if all the recommendations made in the CP have not been complied with, the influence of the contributions of the group of tobacco control advocates to the final version of the warnings is evident. The main contributions considered by Anvisa were: 1) to increase the effectiveness of the health warnings using colored images instead of black and white images, 2) the use of yellow in the upper and lower tiers was also one of the points suggested by the group, and 3) the concept proposed by the group for side warnings was fully complied. What was learned: Civil society participation for the agency´s public policy implementation process is essential and has been possible through the regulatory agenda, public consultations and regular public meetings. However, as is expected, the regulated sector has been quite active. The group recognizes the importance of the Anvisa measure in proposing new health warnings, however, significant recommendations have not been adopted and it may interfere with the goals of the measure. Anvisa´s strategy of allowing the social participation is essential, in accordance with Universal Health System principles and must be maintained. Regarding to the next health warnings and messages on packages of tobacco products, it would be greater to consider higher frequency of updating the images and recover the scientific process of development of the 3rd round of health warnings labels coordinated by the National Institute of Cancer in 2007/2008.


Author(s):  
Jennifer McGowan ◽  
Lion Shahab

Worldwide, tobacco use is a leading cause of morbidity and mortality. However, the health effects of smoking are reversible, making smoking cessation an important target for public health policy. Tobacco control is a field of public health science dedicated to reducing tobacco use and, thereby, to reducing cigarette-related morbidity and mortality. For tobacco control to be effective, it is necessary for policy makers to understand the personal and interpersonal factors which encourage people to smoke, factors which motivate smokers to quit (e.g., health, social pressure, cost), and the personal and population-level methods that are most effective at encouraging and prolonging attempts to quit. Research has identified that social norms, mental health, and individual personality factors are most associated with smoking uptake, so interventions which reduce social smoking (e.g., smoking bans, plain packaging) would be most effective at preventing uptake. Conversely, the use of cigarettes is maintained by nicotine addiction and attempts to quit are often motivated by health concerns, social pressure and the cost of tobacco products. As such, interventions that address physiological and behavioral addiction inherent in tobacco product use (e.g., nicotine replacement therapy combined with counselling), that create social pressure to stop (e.g., mass media campaigns), or that increase the cost of tobacco products are most likely to be effective at encouraging attempts to quit.


2020 ◽  
Vol 24 (3) ◽  
pp. 271-277 ◽  
Author(s):  
H. Guo ◽  
G. Quan

Healthy China 2030 aims to reduce the adult smoking rate from 27.7% in 2015 to 20% by 2030. Achieving this goal requires a review of the tobacco control measures introduced in China to date, the gaps that remain and the opportunities ahead. In 2008, the World Health Organization introduced six measures to reduce demand for tobacco called MPOWER. The progress China has made in implementing these measure varies: 1) monitor tobacco use and prevention policies. The surveillance on tobacco use has been rigorous, but the monitoring and evaluation of tobacco control policies needs to be strengthened; 2) protect people from tobacco use: pushes for national tobacco control legislation have stalled, but 18 subnational legislations have passed; 3) offer help to quit tobacco use. The accessibility and quality of cessation services needs to be improved; 4) warn about the dangers of tobacco. While there are no pictorial health warnings, tobacco control advocates have launched a series of anti-smoking media campaigns to inform the public; 5) enforce bans on tobacco advertising, promotion, and sponsorship. Legal loopholes and poor enforcement remain challenges; 6) raise taxes on tobacco: cigarettes in China are relatively cheap and increasingly affordable, which demonstrates the need for further tobacco tax increases indexed to inflation and income. China maintains a tobacco monopoly that interferes with tobacco control efforts and fails to regulate tobacco products from the public health perspective. Effective MPOWER measures, which depend upon the removal of tobacco industry interference from policymaking, are key to achieving the goal set by Healthy China 2030.


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