Georgia's Tobacco Control Policy Regarding Novel Flavored Tobacco Products - A Comparison to Benchmarks from the European Context.

Introduction: The use of novel tobacco products, such as heated tobacco products (HTPs) and electronic cigarettes (referred to as an electronic nicotine delivery systems (ENDS), and electronic non-nicotine delivery systems (ENNDS)), is increasing among the youth globally. Among the key factors contributing to increased use is tobacco marketing, including advertising emphasizing flavored products, which influences perceptions, especially among youth. In Georgia, recent efforts have strengthened tobacco control, with the "new generation" tobacco control legislation adopted in 2017. Consequently, the trend of individual tobacco product (for example cigarettes) consumption has decreased. However, 2019 researches shows that the trend of using novel tobacco products among young people is increasing. The share of novel tobacco products in the market of Georgia started to grow largely in 2019. Perhaps relatedly, youth continue to show high rates of tobacco consumption in Georgia. The primary aim of this study is to investigate/analyze Georgia's responses to addressing tobacco use in youth and identify gaps and challenges of Georgian policy regarding the regulation of novel tobacco products through comparisons with European policy approaches. Methods: This study identified policy documents specifying legislation (e.g., laws and bylaws, government documents, including state strategies and working plans, official announcements, and minutes from official meetings), through Internet search engines, official legislative web pages, and Ministry websites. Comparative analysis was used to identify challenges in the tobacco control policy of Georgia and assess its alignment with international standards. We compared the features of the Georgian policy with key measures for regulating novel tobacco products outlined in the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) and European Union (EU) legislation (e.g Regulating tobacco product content and disclosure; Packaging and labelling of tobacco products; Tobacco advertising, promotion and sponsorship, tobacco industry interfare in tobacco control policy, etc.). Results: Considering the analysis of effective policy characteristics for preventing tobacco use among young people, as outlined by the WHO and the EU, it is evident that Georgia's tobacco control legislation has significant gaps. Youth prevention policies addressing these products are relatively weak. The current legislation does not include restrictions on marketing of novel tobacco products emphasizing flavors, nor does it include restrictions or limitations on using flavorings/additives in any type of tobacco. Only the concentration of emitted substances in cigarettes and amount of nicotine in e-cigarette liquid is limited. However, compliance with these requirements has never been assessed; There is no local laboratory that tests any kind of tobacco product and no samples have ever been sent to any laboratory abroad. ENNDS represent a particular policy challenge, as they are not considered as tobacco products, and no tobacco control legislative requirements apply to them. Tobacco industry interference with Georgia's tobacco legislation has also been documented to be high; Thus, it is likely that introduction of the control policies on novel product will be met with great resistance, especially since no research has yet been conducted recent years to reveal rates of novel tobacco products use by youth. Conclusions: This study provides the first assessment regarding how Georgia has responded to the growing popularity of novel tobacco products, such as e-cigarettes and HTPs, indicating that its tobacco control legislation has mainly addressed traditional tobacco products but largely neglected these novel products. The tobacco industry has taken advantage of the policy loopholes, and Georgia has become a favorable market for the novel tobacco product industry in recent years. Current findings provide evidence for decision-makers to inform the development of effective regulation and enformcement mechanism of flavored novel tobacco products, as gaps in the current regulations will likely will lead to increased use, particularly among youth.