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Background:
Tobacco is a public health problem with both health and economic consequences. Pictorial health warning (PHW) under cigarettes and other tobacco products Act, May 2003 (COTPA), offers advantages of being more universally available, low cost, and high exposure. The current study aims to assess compliance of smoking and smokeless tobacco...
Context in source publication
Context 1
... this study, "public place" was defined according to COTPA 2003 as "places which have public access, whether as of right or not and includes railway waiting rooms, hospital buildings, restaurants, court buildings, public offices, cinema halls, amusement centers, workplaces, shopping malls, libraries, educational institutions, and public conveyances." [27] This maintained the diversity in terms of geographic location and covered all the nine districts of the state [ Figure 1]. Two trained investigators collected the data from the sites and thus a random sample which was representative of all different/unique brand presentations was collected from tobacco vendors visited across the city. ...
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Citations
... These results confirm those of other studies in India whereby HWLs have low levels of HWL awareness. 16 33 Lack of change in awareness may be attributed to factors that prevent individuals from encountering HWLs, for example, limited manufacturer compliance with the regulations, [34][35][36] illicit SLT and the purchase of loose rather than packaged SLT products. 24 A study that collected SLT packages following increased HWL size requirements reported that while 97.5% of Indian SLT products had an HWL, compliance with all regulations was poor. ...
Background
Smokeless tobacco (SLT) packaging in India had a single symbolic (a scorpion) health warning label (HWL) in 2009 covering 40% of the front surface. In 2011, it was replaced with four pictorial images. In 2016, HWLs were enlarged to 85% on the front and back. This study aimed to assess the effectiveness of the old (symbolic and smaller images) and larger HWLs.
Methods
Data were from the Tobacco Control Project India Survey and included respondents who used SLT in Wave 1 (2010–2011, n=5911), Wave 2 (2012–2013, n=5613) and Wave 3 (2018–2019, n=5636). Using a repeated-measures design, weighted logistic regression models assessed whether there were changes in seven HWL effectiveness measures within the domains of awareness, salience, cognitive and behavioural responses. A cohort design was employed to test whether HWL effectiveness in Waves 1 and 2 was associated with quitting SLT in Waves 2 and 3, respectively.
Results
The 2011 HWL revision did not result in any significant changes in HWL effectiveness. There was no significant change in HWL awareness and salience after larger HWLs were introduced in 2016, but respondents were more likely to consider SLT health risks (Wave 2=17.9%, Wave 3=33.6%, p<0.001) and quitting SLT (Wave 2=18.9%, Wave 3=36.5, p<0.001). There was no change in HWLs stopping SLT use (Wave 2=36.6%, Wave 3=35.2%, p=0.829); however, respondents were more likely to avoid looking at HWLs (Wave 2=10.1%, Wave 3=40.2%, p<0.001). Effectiveness of older, symbolic and smaller pictorial HWLs was not associated with quitting SLT.
Discussion
There was no significant change in HWL effectiveness following the revision from a symbolic to a pictorial image, but enlarging pictorial images resulted in some improved cognitive and behavioural effects. Results suggested wear-out of HWL salience and that the effectiveness of warnings depends on both their design and time since implementation.
... Audio-visual aids should be employed to provide individual counseling, featuring examples of people who have been harmed by tobacco use. Health warnings should also be included in mass media campaigns, and the contact information of tobacco cessation helplines should be printed on tobacco product packaging [15,36]. ...
It is now a legal requirement in India that all tobacco products carry graphic health warnings on their packaging. The Government of India has taken steps to reduce the number of people using tobacco products by introducing the Cigarettes and Other Tobacco Products Act. This law states that all tobacco products must display health warnings on their packaging. Despite this, many people in India still use tobacco products. Graphic health warnings on tobacco packaging and labeling can be an effective way to spread awareness about the risks associated with smoking. Pictures or pictograms should be included on all products, as this can be particularly helpful for those with limited literacy skills. This way, everyone can understand the dangers of tobacco use, even if they cannot read.
This review examines the effectiveness of pictures on cigarette and other tobacco product packages as health warnings in India. To assess the impact of these graphic warnings, research from India was reviewed, along with information from the Ministry of Health and Family Welfare websites and the World Health Organization. The results indicate that the images on packages have some positive effects. However, they need to be made more visible and easier to comprehend to have a more significant influence on discouraging people from taking up smoking.
... Health Warning Label (HWL) is being monitored by the Tobacco Pack Surveillance System (T Pack SS) in India under which 51% of cigarette packs and 2% of smokeless tobacco products were found to be HWL compliant due to the lower literacy rates in rural India [48]. The least compliance to COTPA is shown by foreign cigarette brands (11.1%) and bidi [49]. ...
Tobacco is the only consumer product that kills half its users yearly. The challenges posed by tobacco control are limitless especially in a country like India where in addition to smoked forms, other smokeless forms of tobacco are also highly prevalent. Apart from being a health hazard tobacco is also a great environmental hazard. Policies for controlling tobacco use also include policy to prevent people from second hand smoke, which is aimed at improvement of air quality. According to the National Non-Communicable Disease Monitoring Survey, 2017–18, daily tobacco use was 32.8% in adults (18–69 years) and 3.1% in adolescents (15–17 years). Overall reduction in tobacco users by 8.1 Million was seen from GATS-1 to GATS-2, and prevalence amongst youth decreased from 18.4 to 12.4%. GYTS-4 (2019) revealed that 8.5% of students, 9.6% of boys and 7.4% of girls-currently used any tobacco products. This makes tobacco control a priority in India. Tobacco control consists of different approaches such as educational, healthcare, legislative, regulatory and fiscal. In the present article we traverse nearly five decades and decode the evolution of legislative, regulatory and fiscal approaches to Tobacco Control in India. A critical evaluation of all these approaches is described in the format of the MPOWER strategy for Tobacco Control which stands for Monitoring Tobacco use, Preventing people from Second Hand Smoke, Offering help to quit, Waring regarding ill effects of tobacco, Enforcing bans and Raising taxes on tobacco products.
... (11)(12)(13) Subsequently the Cigarettes and Other Tobacco Products (Packaging and Labelling) Amendment Rules in 2014 mandated a larger health warning label, occupying 85% of the principal display area J o u r n a l P r e -p r o o f of the tobacco package. (14) Despite such efforts the industry continues to manipulate the health warning labels especially on smokeless tobacco products and bidis sold in the country. (15,16) There is also global evidence on the delay of the implementation of health warning policies due to industry interference. ...
... Similar study by Chahar et al. suggested that 25.6 % of the total 98 tobacco products assessed in their study did not contain health warning on both sides of the pack. (14) This difference between the studies can be attributed to the difference in study settingthe latter was restricted to a UT in northern part of India whereas our study included four states located in various parts of India. However, our study findings were reciprocated in the study by Goel (14) The difference in results can be explained by the larger sample size included in our study. ...
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Background
Owing to the role of tobacco packaging as a strong medium of communication, display of health warnings on tobacco packs effectively impart health risks of tobacco consumption to those currently using or contemplating the use of tobacco.
Methods
This community based cross-sectional analytical study was conducted among 2044 tobacco product packs, each collected from a different PoS, to estimate the non-compliance of section 7, 8 & 9 of COTPA among various tobacco products and its association with the PoS characteristics. Data were collected by observation of PoS by field investigators and then purchase of a unique product from each vendor followed by a brief interview of the tobacco vendor.
Results
The study documented an absence of health warning label on 15.51% [95% CI: 13.99-17.13] of the total 2044 tobacco products collected. The non-compliance to ‘quality of health warning picture’ was lowest 5.96% [95% CI: 4.91-7.16] among the tobacco products with a health warning label. The multivariate regression model revealed that absence of health warning on tobacco product packs were higher among the PoS in rural area (aPR 1.38; 95% CI: 1.16-1.65; p<0.001) and among street/mobile vendors (aPR 1.65; 95% CI: 1.22-2.24; p=0.001). The PoS not displaying tobacco products (aPR 1.36; 95% CI: 1.08-1.72; p=0.01), selling flavored chewable tobacco (aPR 1.67; 95% CI: 1.24-2.27; p=0.001), not selling loose cigarettes (aPR 2.93; 95% CI: 1.94-4.43; p<0.001) and with vendors not enquiring age proof (aPR 10.69; 95% CI: 1.59-72.09; p<0.001) had higher proportion of tobacco products without health warning labels. A greater proportion of smokeless/local variety tobacco products (aPR 18.06; 95% CI: 12.31-26.51; p<0.001) had absence of health warning label.
Conclusion
The data provided by us have clear policy implications. We recommend regular enforcement activities to monitor the presence of health warning labels on tobacco product packs along and accurate printing of the same with adherence to the Ministry of Health and Family Welfare templates.
... Dalam metode proses pendidikan, penggunaan metode yang baik adalah metode yang bervariasi atau metode kombinasi dari beberapa metode dan sesuai dengan materi yang disampaikan, sehingga akan mendapatkan hasil yang efek f (Ayatullah, 2019). Hubungan perilaku dengan pendidikan (pengetahuan) sekolah sangatlah erat, karena kesehatan gigi dan mulut dapat dipengaruhi oleh perilaku, hal ini di sampaikan pada Peneli an Chahar (2019) Peneli an Mahmudah (2019), terdapat pengaruh pendidikan gizi menggunakan media teka -teki silang dan media ceramah terhadap pengetahuan gizi seimbang pada anak sekolah dasar. Rata -rata mengalami peningkatan pengetahuan gizi menggunakan teka teki silang lebih nggi dibandingkan dengan menggunakan media ceramah. ...
Penyakit gigi dan mulut yang banyak diderita masyarakat Indonesia adalah penyakit jaringan penyangga gigi dan karies gigi. Sumber kedua penyakit tersebut merupakan akibat dari terabaikannya kebersihan gigi dan mulut. Berdasarkan data dari UPTD Kesehatan Puskesmas Sungai bahwa masih sangat rendahnya pengetahuan kesehatan gigi dan mulut pada anak – anak. Hubungan perilaku dengan pendidikan (pengetahuan) sekolah sangatlah erat, karena kesehatan gigi dan mulut dapat dipengaruhi oleh perilaku. Tujuan penelitian ini adalah untuk mengetahui efektifitas modifikasi Youtube dengan teka - teki silang tentang kesehatan gigi dan mulut terhadap tingkat pengetahuan siswa - siswi SDN 015 Sungai Sirih. Jenis penelitian ini adalah kuantitatif dengan desain Quasi Eksperimen – Nonequivalent Control Design. Sampel pada penelitian ini adalah siswa – siswi kelas V Sekolah Dasar Negeri 015 Sungai Sirih yang berjumlah 54 orang. Data yang dikumpulkan data primer dari pengisian kuesioner pretest danposttest oleh responden. Analisis yang digunakan adalah Uji Wilcoxon dan Kruskal-wallis. Hasil penelitian ini yaitu pengetahuan siswa – siswi yang diberikan edukasi menggunakan Google Form memperoleh rata – rata mean yaitu 38,89 sedangkan yang diberikan edukasi teka – teki silang modifikasi Youtube memperoleh rata – rata yaitu 79,94. Media teka – teki silang modifikasi Youtube telah terbukti dalam meningkatkan pengetahuan siswa – siswi terhadap kesehatan gigi dan mulut di Sekolah Dasar Negeri 015 Sungai Sirih dengan kategori tingkat pengetahuan meningkat 100%. Kesimpulan media sosial Youtubemodifikasi teka teki silang sangat efektif pada penyuluhan kesehatan gigi dan mulut. Peneliti menyarankan untuk puskesmas dan peneliti selanjutnya untuk menggunakan strategi lain dalam penyuluhan kesehatan gigi mulut.
Objective:
Tobacco use is associated with mortality in low- and middle-income countries including India with dual burden of smoking and smokeless tobacco (SLT). Aligning with the FCTC, India has made substantial amendments in strengthening graphic warning under Cigarettes and Other Tobacco Products Act (COTPA) for sections 7,8 9 and "Specified warning". Compliance assessment studies are necessary to understand current status of implementation for packaging laws. This study aimed to assess the compliance of COTPA sections 7,8 9 and Cigarettes and other Tobacco Products (Packaging and Labelling) Third Amendment Rules, 2020 in Delhi.
Methods:
Cross-sectional study was conducted in two districts of Delhi selected by simple random sampling. Fifteen points of sales were selected from each district through purposive sampling and 57 smoking and smokeless tobacco products were collected with Indian and foreign origin. An observation checklist for product analysis was prepared and pack analysis done based on COTPA sections 7,8 and 9 along with Third Amendment,2020 which included pictures and warnings to be circulated in 2021.
Result:
Total 57 samples has smoking (49.1%), smokeless (50.9%) with no SLT product of foreign origin. SLT and foreign products had low compliance of Section 7 and third amendment 2020 rules which includes manufacturing date and origin. Indian smoking products were highly compliant to section 8 and 9 whereas foreign and SLT products showed low compliance to section 8. COTPA Third Amendment Rules (2020) compliance was seen in Indian products with regards to SW (68.4%), PW (61.4%) and quit line (78.9%) with no compliance at all for foreign products.
Conclusion:
Foreign brands and SLT products had low compliance with sections 7 and 8 of COTPA and its amendments (2020). Compliance with illicit trade and SW needs regulation and strict implementation of law for SLT products.
