Evidence map›Paper›PMID 36167826›Full record

ArticleTobacco control2024

Non-compliant packaging and illicit smokeless tobacco in Bangladesh, India and Pakistan: findings of a pack analysis.

S M Abdullah, Rumana Huque, Kamran Siddiqi, Mona Kanaan, Samina Huque, Safat Ullah, Suneela Garg, Mongjam Meghachandra Singh, Chetana Deshmukh, Amod L Borle and 6 more

Open access · hybridAbstract read
In one paragraph

Article in Tobacco control, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Smokeless tobacco: knowledge, attitudes and usage in Pakistan.Journal of health, population, and nutrition · 2025
    Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 8 institutions in 5 countries.

S M AbdullahHealth Sciences, University of York, York, UK sa2217@york.ac.uk.ORCID 0000-0003-2083-2253
Rumana HuqueDepartment of Economics, University of Dhaka, Dhaka, Dhaka District, Bangladesh.
Kamran SiddiqiHealth Sciences, University of York, York, UK.ORCID 0000-0003-1529-7778
Mona KanaanHealth Sciences, University of York, York, UK.
Samina HuqueResearch and Development, ARK Foundation, Dhaka, Bangladesh.
Safat UllahOffice of Research Innovation and Commercialization, Khyber Medical University, Pehsawar, Khyber Pakhtunkhwa, Pakistan.
Suneela GargDepartment of Community Medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India.
Mongjam Meghachandra SinghDepartment of Community Medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India.
Chetana DeshmukhDepartment of Community Medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India.
Amod L BorleDepartment of Community Medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi, Delhi, India.
Romaina IqbalDepartment of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Laraib MazharDepartment of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Mark ParascandolaNational Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, Maryland, USA.ORCID 0000-0001-6071-8493
Ravi MehrotraIndian Council of Medical Research (ICMR) - Indian Cancer Research Consortium, New Delhi, Delhi, India.
Ray CroucherHealth Sciences, University of York, York, UK.
Zohaib KhanOffice of Research Innovation and Commercialization, Khyber Medical University, Pehsawar, Khyber Pakhtunkhwa, Pakistan.ORCID 0000-0002-1885-8254
Maulana Azad Medical College · INUniversity of York · GBAga Khan University · PKKhyber Medical University · PKUniversity of Dhaka · BDARK Foundation · BDIndian Council of Medical Research · INNational Cancer Institute · US

Funding

Medical Research Council MR/X004228/1
6 · The paper itself

Abstract

introductionIllicit smokeless tobacco (ST) trade has seldom been documented despite ST use in at least 127 countries across the world. Based on non-compliance with packaging regulations, we report the proportion of illicit ST products from samples on sale in Bangladesh, India and Pakistan where 85% of global ST users reside.

methodsWe purchased unique ST products from tobacco sellers in two purposively selected administrative areas (division/district) in each of the three countries. The criteria to determine illicit ST products were based on country-specific legal requirements for ST packaging and labelling. These requirements included: 'market retail price disclosure', 'sale statement disclosure', 'pictorial health warning (PHW) pertinence', 'appropriate textual health warning' and 'using misleading descriptors (MDs)'. Non-compliance with even one of the legal requirements was considered to render the ST product illicit.

resultsAlmost all ST products bought in Bangladesh and India were non-compliant with the local packaging requirements and hence potentially illicit, all products in Pakistan lacked desirable features. The most common feature missing was health warnings: 84% packs in Bangladesh, 93% in India, and 100% in Pakistan either did not have PHW or their sizes were too small. In Bangladesh, 61% packs carried MDs. In India and Pakistan, the proportions of such packs were 32% and 42%, respectively.

conclusionsWeak and poorly enforced ST control policies may be slowing the progress of tobacco control in South Asia. Standardised regulations are required for packaging and labelling ST. Improving compliance and reducing sale of cheap illicit products may require business licensing and market surveillance.

Indexed as

Tobacco ProductsTobacco, SmokelessBangladeshCommerceHumansIndiaPakistanProduct Packagingillegal tobacco productslow/middle income countrynon-cigarette tobacco productspackaging and Labellingsurveillance and monitoring

Identifiers

PMID36167826
PMCPMC11041550
OpenAlexW4297325223

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.