ArticleTobacco induced diseases2025
Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions.
Article in Tobacco induced diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
introductionApproximately 21% of adults in India use smokeless tobacco and over half use khaini, a tobacco-lime mixture. Khaini is available in a variety of pack shapes and sizes, which can affect health warning label (HWL) size and placement. This study explored consumer perceptions of existing khaini packs and two proposed standard shape/size khaini packs across dimensions of HWL noticeability and harm perceptions.
methodsIn March 2023, we conducted 24 focus groups (FGs) across India. Groups were equally numbered by residence, gender, and current khaini use. FGs were led by trained facilitators. Each FG discussed six existing khaini packs and two standard packs (paper sachet; tin cylinder). Data were collected in local languages, translated into English, and thematically analyzed.
resultsAll FGs discussed the limited visibility of HWLs on existing packs, noting that HWLs were often small, blurry, or printed too faintly to notice. Most (defined as ≥80%) FGs discussed how the HWLs on both standard packs were large and easy to see. FGs discussed how the standard packs appeared more harmful than existing packs due to the large, clearly printed HWL. Most FGs found that the standard tin cylinder was less harmful than the standard paper sachet due to its comparatively smaller HWL.
conclusionsBoth standard khaini packs increased HWL noticeability and perceived harm compared to existing packs, and the standard paper sachet was seen as more harmful than the standard tin cylinder. Implementing the standard sachet pack could enhance HWL visibility and increase perceptions of harm among consumers.
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