‘Symposium on Applied Research in Tobacco Control and Regional Stakeholder Meeting’ (Virtual) was held on 16th September 2021 in association with the Tobacco Control Capacity Programme and State Tobacco Control Cell, Government of Karnataka. Dr. Upendra Bhojani (Director, IPH-Bengaluru) was invited to talk about Tobacco Industry Interference (TII) prevention measures for Karnataka. The event was organised by Manipal Academy of Higher Education (MAHE).
(BMJ) Tobacco Control recently published a paper by Dr. Upendra Bhojani and Riddhi Dsouza from the DEEP project at the Institute of Public Health, Bengaluru. The paper analysed how several states in India used food laws to ban certain smokeless tobacco products overcoming the intense legal resistance mounted by the tobacco industry. This was done by analysing all the tobacco-related litigations under food law in the High Courts and the Supreme Court of India. The full text of the paper titled “Strategic and contested use of food laws to ban smokeless tobacco products in India: a qualitative analysis of litigation” can be found here.
Dr. Pragati Hebbar together with Vivek Dsouza, Upendra Bhojani, Onno CP van Schayck, Dr. Giridhara Babu, and Gera Nagelhout co-authored a protocol paper titled “Implementation research for taking tobacco control policies to scale in India: a realist evaluation study protocol”. This protocol is part of project ‘Anushthana’ and outlines the five-year study undertaken within the Chronic Conditions and Public Policies cluster at the Institute of Public Health (IPH). Tobacco use is responsible for 1.3 million deaths in India each year and is a major public health threat. Although comprehensive tobacco control measures like the Cigarettes and Other Tobacco Products Act (COTPA), 2003, and the National Tobacco Control Programme (NTCP) exist, implementation remains varied and suboptimal across Indian states. Through this study protocol, our attempt is to understand the implementation landscape in India with respect to tobacco control.
We do this by
- Assessing the implementation process of current tobacco control policies.
- Identifying the underlying conditions for variation during implementation
- Identifying the factors that support or undermine implementation in settings where issues around tobacco are complex and multi-dimensional.
Anushthana is funded by the DBT/Wellcome Trust India Alliance. The protocol paper is published in BMJ Open and can be accessed here
Dr. Upendra Bhojani, co-authored a paper in Population Medicine journal, along with Dr. Pragati Hebbar and Amiti Varma from the Chronic Conditions and Public Policies cluster at IPH-Bengaluru. The paper evaluated a school-based tobacco/supari cessation intervention programme helping corporation school students in Mumbai. This quasi-experimental study was conducted using a difference-in-difference analysis approach. The full-text can be accessed here.
In two separate workshops held in December last year, Dr. Upendra Bhojani (Director, IPH-Bengaluru) was invited to serve as a resource person (virtual) on Tobacco Industry Interference (TII). The workshops were held in Chhattisgarh (16th December, 2020) and Manipur (21st December, 2020).
Dr. Bhojani spoke about TII and the broad array of tactics and strategies used directly or indirectly by the tobacco industry to interfere with, or influence, the setting and implementation of effective tobacco control measures as per Article 5.3 of the WHO FCTC guidelines.
The State level Consultation Workshops were organised by the State Tobacco Control Cell of the respective states.
Dr. Upendra Bhojani, co-authored a paper in the BMJ Global Health, along with Amiti Varma & Latha Chilgod of the Institute of Public Health, Bengaluru. This is the first peer-reviewed paper from the DEEP project titled “Diverse and competing interests around tobacco: qualitative analysis of two decades of parliamentary questions in India”. The paper analysed 1315 tobacco-related questions asked by 729 MPs over the two decades (1999-2019).
MPs had concerns about health (consumption patterns; harms; cessation; regulations); trade (production & export; Tobacco Board of India; market growth); agriculture (support for farmers); labour (working conditions; alternative livelihoods; impacts of regulations). The nature of concerns changed over time with health becoming a dominant concern. Other issues like trade took somewhat of a back seat, possibly due to a growing awareness on health harms and incremental tobacco control regulations.
Livelihood and economy-related concerns persisted throughout. The number of MPs asking tobacco-related questions varied widely across states. States, from where maximum MPs asked questions (Andhra Pradesh; Maharashtra; Uttar Pradesh; Karnataka; Tamil Nadu in that order) are the states with a greater presence of tobacco industry.
Key takeaways: (1) parliamentary questions, that remain underutilized in health policy research, could be a useful resource; (2) tobacco evokes diverse & competing interests implying a need for careful mediation and consultative approach to policy making for public health gains; (3) In India, state-level (economic, political, historical, cultural) contexts are crucial in understanding the political economy of tobacco and formulating tobacco control regulations; (4) identifying key concerns help public health folks engage with diverse political voices when tobacco control reforms are planned/executed enhancing political support across sectors and constituencies for tobacco control.