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Mycotoxins, such as aflatoxins, fumonisins, trichothecenes, and zearalenone, are increasing in visibility as a public health threat through both acute and chronic exposure in food. USAID through its Feed the Future program has sponsored research in Nepal on mycotoxin contamination and the correlated high levels of stunting in children under age five. Communicating about mycotoxins is a complicated matter, as is communicating about any potentially serious economic or health threat that may be difficult to control. Two nominal group workshops in Nepal focused on identifying problems from multiple perspectives and developing potential communication strategies to mitigate the problem and potential concerns about it. Target audiences were identified along with their interests and effective channels to communicate with and within them. The first audience to work with is the government, as it must understand and value the problem and help generate confidence in potential regulatory and mitigation processes. Producers, educators and health professionals are the next audiences to address as they are the most closely involved with the problem. Consumer engagement is last, with a communication goal of sharing information to heighten awareness and minimize unwarranted public concern.

IntroductionIncreasing the tax on cigarettes is widely considered the most effective method to reduce its consumption. However, Nepal has a low cigarette tax as policymakers in Nepal are concerned about illicit trade of cigarettes if taxes are increased.MethodsThe study employed a retail survey approach used in India suitable for countries with prevalent loose cigarette sales, with improved methodology. In 2021, empty cigarette packs generated in a day’s loose cigarette sales were collected directly from cigarette retailers from 23 primary sampling units covering rural/urban, geographic divisions, border/non-border to India and tobacco factory locations. The central points of each primary sampling unit were identified, and retailers were selected for the survey. A cigarette pack was classified as illicit if it had at least one of the following attributes: (a) no authentic excise duty sticker, (b) no graphic health warning, (c) no mention of ‘maximum retail price/MRP’ and (d) no production date, name, address and trademark.FindingsWe collected 4307 empty cigarette packs from 1204 retailers and 0.33% of them were classified as illicit. The estimates varied across location with the highest prevalence of illicit packs in Kathmandu (1.25%). All the illicit cigarettes were imported and were high-priced brands (>90%), mostly found in urban areas and not bordering India.ConclusionOur estimate of the illicit cigarette market share of 0.33% suggests that the industry’s statement of 25% is grossly overstated.