Insights into Pictorial Health Warnings on Tobacco ProductPackages Marketed in Uttar Pradesh, India

Abstract

<b>Background:</b> The Government of India issued an undertaking in the Supreme Court mandating pictorialhealth warnings (PHWs) on packages of tobacco products from 31st May, 2009 under “Cigarettes and OtherTobacco Products Act” (COTPA) guidelines. This constitutes a key economic channel for educating people ondevastating health impacts of deadly products within in a vivid and memorable way. Few studies have investigatedPHWs on tobacco products marketed in India. <br/><b>Objectives</b>: To assess met guidelines for pictorial health warningsunder packaging and labeling rules on packages of collected tobacco products specified by COTPA. Materialsand <br/><b>Methods</b>: Snowball/network sampling design was followed to obtain samples of 37 different tobacco brands,18 in smoking form (12 cigarette, 6 bidi brands) and 19 in smokeless form (4 chewing tobacco, 11 Gutkha and4 Khaini brands) marketed at retail outlets at Muradnagar. They were analyzed for their compliance withguidelines through checklist by one calibrated examiner. <br/><b>Results</b>: PHWs were absent on packages of 5 tobaccobrands. Fifteen tobacco brands had PHWs smaller than stipulated 40% of principal display area; 6 brands ofbidis had PHWs on deceptive backgrounds, 3 of which were placed on a curved axis. Misleading descriptors andpromotional messages were also present. <br/><b>Conclusion</b>: Locally marketed tobacco products were not compliant withpackaging and labeling rules specified by COTPA. This highlights the need for more stringent implementationof COTPA guidelines to combat the ever-growing tobacco menace.