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
Open Access
- 1 June 2020
- Vol. 10 (6), e036468
- https://doi.org/10.1136/bmjopen-2019-036468
Abstract
Introduction South Asia is home to more than 300 million smokeless tobacco (Si) 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.Funding Information
- National Institute for Health Research (17/63/76)
This publication has 28 references indexed in Scilit:
- The Tobacco Pack Surveillance System: A Protocol for Assessing Health Warning Compliance, Design Features, and Appeals of Tobacco Packs Sold in Low- and Middle-Income CountriesJMIR Public Health and Surveillance, 2015
- Smokeless Tobacco Supply Chain in South Asia: A Comparative Analysis Using the WHO Framework Convention on Tobacco ControlNicotine & Tobacco Research, 2015
- Earned Media and Public Engagement With CDC’s "Tips From Former Smokers" Campaign: An Analysis of Online News and Blog CoverageJournal of Medical Internet Research, 2015
- Betel quid chewing and the risk of oral and oropharyngeal cancers: A meta-analysis with implications for cancer controlInternational Journal of Cancer, 2014
- Using the framework method for the analysis of qualitative data in multi-disciplinary health researchBMC Medical Research Methodology, 2013
- Tobacco industry tactics with advertisements at the point of sale in MumbaiIndian Journal of Cancer, 2013
- Active smoking and secondhand smoke increase breast cancer risk: the report of the Canadian Expert Panel on Tobacco Smoke and Breast Cancer Risk (2009)Tobacco Control, 2010
- Global surveillance of oral tobacco products: total nicotine, unionised nicotine and tobacco-specific N-nitrosaminesTobacco Control, 2010
- Smokeless tobacco and cancerThe Lancet Oncology, 2008
- WHO Framework Convention on Tobacco Control: development of an evidence based global public health treatyBMJ, 2003