Compliance of smokeless tobacco supply chain actors and products with tobacco control laws in Bangladesh, India and Pakistan : protocol for a multicentre sequential mixed-methods study
- Khan, Zohaib, Huque, Rumana, Sheikh, Aziz, Readshaw, Anne, Eckhardt, Jappe, Jackson, Cath, Kanaan, Mona, Iqbal, Romaina, Akhter, Zohaib, Garg, Suneela, Singh, Mongjam, Ahmad, Fayaz, Abdullah, S.M., Javaid, Arshad, A Khan, Javaid, Han, Lu, Rahman, Muhammad Aziz, Siddiqi, Kamran
- Authors: Khan, Zohaib , Huque, Rumana , Sheikh, Aziz , Readshaw, Anne , Eckhardt, Jappe , Jackson, Cath , Kanaan, Mona , Iqbal, Romaina , Akhter, Zohaib , Garg, Suneela , Singh, Mongjam , Ahmad, Fayaz , Abdullah, S.M. , Javaid, Arshad , A Khan, Javaid , Han, Lu , Rahman, Muhammad Aziz , Siddiqi, Kamran
- Date: 2020
- Type: Text , Journal article
- Relation: BMJ Open Vol. 10, no. 6 (2020), p.
- Full Text:
- Reviewed:
- Description: Introduction South Asia is home to more than 300 million smokeless tobacco (ST) users. Bangladesh, India and Pakistan as signatories to the Framework Convention for Tobacco Control (FCTC) have developed policies aimed at curbing the use of tobacco. The objective of this study is to assess the compliance of ST point-of-sale (POS) vendors and the supply chain with the articles of the FCTC and specifically with national tobacco control laws. We also aim to assess disparities in compliance with tobacco control laws between ST and smoked tobacco products. Methods and analysis The study will be carried out at two sites each in Bangladesh, India and Pakistan. We will conduct a sequential mixed-methods study with five components: (1) mapping of ST POS, (2) analyses of ST samples packaging, (3) observation, (4) survey interviews of POS and (5) in-depth interviews with wholesale dealers/suppliers/manufacturers of ST. We aim to conduct at least 300 POS survey interviews and observations, and 6-10 in-depth interviews in each of the three countries. Data collection will be done by trained data collectors. The main statistical analysis will report the frequencies and proportions of shops that comply with the FCTC and local tobacco control policies, and provide a 95% CI of these estimates. The qualitative in-depth interview data will be analysed using the framework approach. The findings will be connected, each component informing the focus and/or design of the next component. Ethics and dissemination Ethical approvals for the study have been received from the Health Sciences Research Governance Committee at the University of York, UK. In-country approvals were taken from the National Bioethics Committee in Pakistan, the Bangladesh Medical Research Council and the Indian Medical Research Council. Our results will be disseminated via scientific conferences, peer-reviewed research publications and press releases. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
- Description: National Institute for Health Research, NIHR [ASTRA (Grant Reference Number 17/63/76)].
- Authors: Khan, Zohaib , Huque, Rumana , Sheikh, Aziz , Readshaw, Anne , Eckhardt, Jappe , Jackson, Cath , Kanaan, Mona , Iqbal, Romaina , Akhter, Zohaib , Garg, Suneela , Singh, Mongjam , Ahmad, Fayaz , Abdullah, S.M. , Javaid, Arshad , A Khan, Javaid , Han, Lu , Rahman, Muhammad Aziz , Siddiqi, Kamran
- Date: 2020
- Type: Text , Journal article
- Relation: BMJ Open Vol. 10, no. 6 (2020), p.
- Full Text:
- Reviewed:
- Description: Introduction South Asia is home to more than 300 million smokeless tobacco (ST) users. Bangladesh, India and Pakistan as signatories to the Framework Convention for Tobacco Control (FCTC) have developed policies aimed at curbing the use of tobacco. The objective of this study is to assess the compliance of ST point-of-sale (POS) vendors and the supply chain with the articles of the FCTC and specifically with national tobacco control laws. We also aim to assess disparities in compliance with tobacco control laws between ST and smoked tobacco products. Methods and analysis The study will be carried out at two sites each in Bangladesh, India and Pakistan. We will conduct a sequential mixed-methods study with five components: (1) mapping of ST POS, (2) analyses of ST samples packaging, (3) observation, (4) survey interviews of POS and (5) in-depth interviews with wholesale dealers/suppliers/manufacturers of ST. We aim to conduct at least 300 POS survey interviews and observations, and 6-10 in-depth interviews in each of the three countries. Data collection will be done by trained data collectors. The main statistical analysis will report the frequencies and proportions of shops that comply with the FCTC and local tobacco control policies, and provide a 95% CI of these estimates. The qualitative in-depth interview data will be analysed using the framework approach. The findings will be connected, each component informing the focus and/or design of the next component. Ethics and dissemination Ethical approvals for the study have been received from the Health Sciences Research Governance Committee at the University of York, UK. In-country approvals were taken from the National Bioethics Committee in Pakistan, the Bangladesh Medical Research Council and the Indian Medical Research Council. Our results will be disseminated via scientific conferences, peer-reviewed research publications and press releases. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
- Description: National Institute for Health Research, NIHR [ASTRA (Grant Reference Number 17/63/76)].
- Causey, Kate, Salvi, Devashri, Abbafati, Cristiana, Adekanmbi, Victor, Adsuar, Jose, Ahmadi, Keivan, Alahdab, Fares, Andrei, Catalina, Arabloo, Jalal, Aripov, Timur, Babaee, Ebrahim, Barnett, Anthony, Bedi, Neeraj, Béjot, Yannick, Bernstein, Robert, Bijani, Ali, Brenner, Hermann, Butt, Zahid, Cantu-Brito, Carlos, Chauhan, Bal Govind, Choi, Jee-Young Jasmine, Dai, Xiaochen, Dandona, Lalit, Dandona, Rakhi, Daryani, Ahmad, Davletov, Kairat, Dharmaratne, Samath, Diaz, Daniel, Duncan, Bruce, Fattahi, Nazir, Fazlzadeh, Mehdi, Fernandes, Eduarda, Filip, Irina, Foigt, Nataliya, Freitas, Marisa, Gill, Paramjit Singh, Habtewold, Tesfa, Hamadeh, Randah, Hasanpoor, Edris, Heibati, Behzad, Househ, Mowafa, Jaafari, Jalil, Jakovljevic, Mihajlo, Jha, Ravi Prakash, Jonas, Jost, Khafaie, Morteza, Khatab, Khaled, Kivimäki, Mika, Koyanagi, Ai, Lee, Paul, Lewycka, Sonia, Li, Shanshan, Lim, Lee-Ling, Mahotra, Narayan, Majeed, Azeem, Maleki, Afshin, Mamun, Abdullah, Martini, Santi, Meharie, Birhanu, Menezes, Ritesh, Mestrovic, Tomislav, Miazgowski, Tomasz, Mini, G. K., Mirica, Andreea, Mohan, Viswanathan, Moraga, Paula, Morrison, Shane, Mueller, Ulrich, Mukhopadhyay, Satinath, Mustafa, Ghulam, Nangia, Vinay, Ningrum, Dina, Owolabi, Mayowa, P A, Mahesh, Pourjafar, Hadi, Rafiei, Alireza, Rai, Rajesh, Raoofi, Samira, Renzaho, Andre, Ronfani, Luca, Sabour, Siamak, Sadeghi, Ehsan, Sarmiento-Suárez, Rodrigo, Schutte, Aletta, Sharafi, Kiomars, Sheikh, Aziz, Shirkoohi, Reza, Shuval, Kerem, Soyiri, Ireneous, Topor-Madry, Roman, Ullah, Irfan, Vacante, Marco, Violante, Francesco, Waheed, Yasir, Wolfe, Charles, Yamada, Tomohide, Yonemoto, Naohiro, Yu, Chuanhua, Zaman, Sojib, Brauer, Michael
- Authors: Causey, Kate , Salvi, Devashri , Abbafati, Cristiana , Adekanmbi, Victor , Adsuar, Jose , Ahmadi, Keivan , Alahdab, Fares , Andrei, Catalina , Arabloo, Jalal , Aripov, Timur , Babaee, Ebrahim , Barnett, Anthony , Bedi, Neeraj , Béjot, Yannick , Bernstein, Robert , Bijani, Ali , Brenner, Hermann , Butt, Zahid , Cantu-Brito, Carlos , Chauhan, Bal Govind , Choi, Jee-Young Jasmine , Dai, Xiaochen , Dandona, Lalit , Dandona, Rakhi , Daryani, Ahmad , Davletov, Kairat , Dharmaratne, Samath , Diaz, Daniel , Duncan, Bruce , Fattahi, Nazir , Fazlzadeh, Mehdi , Fernandes, Eduarda , Filip, Irina , Foigt, Nataliya , Freitas, Marisa , Gill, Paramjit Singh , Habtewold, Tesfa , Hamadeh, Randah , Hasanpoor, Edris , Heibati, Behzad , Househ, Mowafa , Jaafari, Jalil , Jakovljevic, Mihajlo , Jha, Ravi Prakash , Jonas, Jost , Khafaie, Morteza , Khatab, Khaled , Kivimäki, Mika , Koyanagi, Ai , Lee, Paul , Lewycka, Sonia , Li, Shanshan , Lim, Lee-Ling , Mahotra, Narayan , Majeed, Azeem , Maleki, Afshin , Mamun, Abdullah , Martini, Santi , Meharie, Birhanu , Menezes, Ritesh , Mestrovic, Tomislav , Miazgowski, Tomasz , Mini, G. K. , Mirica, Andreea , Mohan, Viswanathan , Moraga, Paula , Morrison, Shane , Mueller, Ulrich , Mukhopadhyay, Satinath , Mustafa, Ghulam , Nangia, Vinay , Ningrum, Dina , Owolabi, Mayowa , P A, Mahesh , Pourjafar, Hadi , Rafiei, Alireza , Rai, Rajesh , Raoofi, Samira , Renzaho, Andre , Ronfani, Luca , Sabour, Siamak , Sadeghi, Ehsan , Sarmiento-Suárez, Rodrigo , Schutte, Aletta , Sharafi, Kiomars , Sheikh, Aziz , Shirkoohi, Reza , Shuval, Kerem , Soyiri, Ireneous , Topor-Madry, Roman , Ullah, Irfan , Vacante, Marco , Violante, Francesco , Waheed, Yasir , Wolfe, Charles , Yamada, Tomohide , Yonemoto, Naohiro , Yu, Chuanhua , Zaman, Sojib , Brauer, Michael
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet. Planetary health Vol. 6, no. 7 (2022), p. e586-e600
- Full Text: false
- Reviewed:
- Description: Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Bill & Melinda Gates Foundation.
The global impact of tobacco control policies on smokeless tobacco use : a systematic review
- Chugh, Aastha, Arora, Monika, Jain, Neha, Vidyasagaran, Aishwarya, Readshaw, Anne, Sheikh, Aziz, Eckhardt, Jappe, Siddiqi, Kamran, Chopra, Mansi, Mishu, Masuma, Kanaan, Mona, Rahman, Muhammad Aziz, Mehrotra, Ravi, Huque, Rumana, Forberger, Sarah, Dahanayake, Suranji, Khan, Zohaib, Boeckmann, Melanie, Dogar, Omara
- Authors: Chugh, Aastha , Arora, Monika , Jain, Neha , Vidyasagaran, Aishwarya , Readshaw, Anne , Sheikh, Aziz , Eckhardt, Jappe , Siddiqi, Kamran , Chopra, Mansi , Mishu, Masuma , Kanaan, Mona , Rahman, Muhammad Aziz , Mehrotra, Ravi , Huque, Rumana , Forberger, Sarah , Dahanayake, Suranji , Khan, Zohaib , Boeckmann, Melanie , Dogar, Omara
- Date: 2023
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 11, no. 6 (2023), p. e953-e968
- Full Text:
- Reviewed:
- Description: Background: Smokeless tobacco, used by more than 300 million people globally, results in substantial morbidity and mortality. For smokeless tobacco control, many countries have adopted policies beyond the WHO Framework Convention on Tobacco Control, which has been instrumental in reducing smoking prevalence. The impact of these policies (within and outside the Framework Convention on Tobacco Control) on smokeless tobacco use remains unclear. We aimed to systematically review policies that are relevant to smokeless tobacco and its context and investigate their impact on smokeless tobacco use. Methods: In this systematic review, we searched 11 electronic databases and grey literature between Jan 1, 2005, and Sept 20, 2021, in English and key south Asian languages, to summarise smokeless tobacco policies and their impact. Inclusion criteria were all types of studies on smokeless tobacco users that mentioned any smokeless tobacco relevant policies since 2005, except systematic reviews. Policies issued by organisations or private institutions were excluded as well as studies on e-cigarettes and Electronic Nicotine Delivery System except where harm reduction or switching were evaluated as a tobacco cessation strategy. Two reviewers independently screened articles, and data were extracted after standardisation. Quality of studies was appraised using the Effective Public Health Practice Project's Quality Assessment Tool. Outcomes for impact assessment included smokeless tobacco prevalence, uptake, cessation, and health effects. Due to substantial heterogeneity in the descriptions of policies and outcomes, data were descriptively and narratively synthesised. This systematic review was registered in PROSPERO (CRD42020191946). Findings: 14 317 records were identified, of which 252 eligible studies were included as describing smokeless tobacco policies. 57 countries had policies targeting smokeless tobacco, of which 17 had policies outside the Framework Convention on Tobacco Control for smokeless tobacco (eg, spitting bans). 18 studies evaluated the impact, which were of variable quality (six strong, seven moderate, and five weak) and reported mainly on prevalence of smokeless tobacco use. The body of work evaluating policy initiatives based on the Framework Convention on Tobacco Control found that these initiatives were associated with reductions in smokeless tobacco prevalence of between 4·4% and 30·3% for taxation and 22·2% and 70·9% for multifaceted policies. Two studies evaluating the non-Framework policy of sales bans reported significant reductions in smokeless tobacco sale (6·4%) and use (combined sex 17·6%); one study, however, reported an increased trend in smokeless tobacco use in the youth after a total sales ban, likely due to cross-border smuggling. The one study reporting on cessation found a 13·3% increase in quit attempts in individuals exposed (47·5%) to Framework Convention on Tobacco Control policy: education, communication, training, and public awareness, compared with non-exposed (34·2%). Interpretation: Many countries have implemented smokeless tobacco control policies, including those that extend beyond the Framework Convention on Tobacco Control. The available evidence suggests that taxation and multifaceted policy initiatives are associated with meaningful reductions in smokeless tobacco use. Funding: UK National Institute for Health Research. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
- Authors: Chugh, Aastha , Arora, Monika , Jain, Neha , Vidyasagaran, Aishwarya , Readshaw, Anne , Sheikh, Aziz , Eckhardt, Jappe , Siddiqi, Kamran , Chopra, Mansi , Mishu, Masuma , Kanaan, Mona , Rahman, Muhammad Aziz , Mehrotra, Ravi , Huque, Rumana , Forberger, Sarah , Dahanayake, Suranji , Khan, Zohaib , Boeckmann, Melanie , Dogar, Omara
- Date: 2023
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 11, no. 6 (2023), p. e953-e968
- Full Text:
- Reviewed:
- Description: Background: Smokeless tobacco, used by more than 300 million people globally, results in substantial morbidity and mortality. For smokeless tobacco control, many countries have adopted policies beyond the WHO Framework Convention on Tobacco Control, which has been instrumental in reducing smoking prevalence. The impact of these policies (within and outside the Framework Convention on Tobacco Control) on smokeless tobacco use remains unclear. We aimed to systematically review policies that are relevant to smokeless tobacco and its context and investigate their impact on smokeless tobacco use. Methods: In this systematic review, we searched 11 electronic databases and grey literature between Jan 1, 2005, and Sept 20, 2021, in English and key south Asian languages, to summarise smokeless tobacco policies and their impact. Inclusion criteria were all types of studies on smokeless tobacco users that mentioned any smokeless tobacco relevant policies since 2005, except systematic reviews. Policies issued by organisations or private institutions were excluded as well as studies on e-cigarettes and Electronic Nicotine Delivery System except where harm reduction or switching were evaluated as a tobacco cessation strategy. Two reviewers independently screened articles, and data were extracted after standardisation. Quality of studies was appraised using the Effective Public Health Practice Project's Quality Assessment Tool. Outcomes for impact assessment included smokeless tobacco prevalence, uptake, cessation, and health effects. Due to substantial heterogeneity in the descriptions of policies and outcomes, data were descriptively and narratively synthesised. This systematic review was registered in PROSPERO (CRD42020191946). Findings: 14 317 records were identified, of which 252 eligible studies were included as describing smokeless tobacco policies. 57 countries had policies targeting smokeless tobacco, of which 17 had policies outside the Framework Convention on Tobacco Control for smokeless tobacco (eg, spitting bans). 18 studies evaluated the impact, which were of variable quality (six strong, seven moderate, and five weak) and reported mainly on prevalence of smokeless tobacco use. The body of work evaluating policy initiatives based on the Framework Convention on Tobacco Control found that these initiatives were associated with reductions in smokeless tobacco prevalence of between 4·4% and 30·3% for taxation and 22·2% and 70·9% for multifaceted policies. Two studies evaluating the non-Framework policy of sales bans reported significant reductions in smokeless tobacco sale (6·4%) and use (combined sex 17·6%); one study, however, reported an increased trend in smokeless tobacco use in the youth after a total sales ban, likely due to cross-border smuggling. The one study reporting on cessation found a 13·3% increase in quit attempts in individuals exposed (47·5%) to Framework Convention on Tobacco Control policy: education, communication, training, and public awareness, compared with non-exposed (34·2%). Interpretation: Many countries have implemented smokeless tobacco control policies, including those that extend beyond the Framework Convention on Tobacco Control. The available evidence suggests that taxation and multifaceted policy initiatives are associated with meaningful reductions in smokeless tobacco use. Funding: UK National Institute for Health Research. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
- «
- ‹
- 1
- ›
- »