Perception of tobacco use in young adults in urban India: a qualitative exploration with relevant health policy analysis

Abstract

Tobacco is one of the biggest global health concerns of this century with a significant contribution to the increasing burden of cancers, chronic diseases and associated mortality. Tobacco-related cancers are one of the commonest causes of cancer-related mortality in low- and middle-income countries (LMICs). The tobacco epidemic is constantly on the rise, affecting LMICs in particular due to a lack of awareness in the population, insufficient health infrastructure and weak regulatory interventions. India is home to the world’s largest youth population and a large percentage of them take up tobacco at a very young age, leading to subsequent habit formation. There is limited evidence in published research from India on young people’s perceptions on the use and control of tobacco. This qualitative study has attempted to bridge that knowledge gap; a thematic analysis was used on the qualitative data gathered from young university students who participated in interviews and focus group discussions, which was then compared and contrasted with a critical analysis of India’s national tobacco control measures. It employed a health policy analysis framework to understand how gaps in the national tobacco control initiatives contribute towards tobacco use in young people and what opportunities for policy reform exist. The main results revealed social and behavioural factors, peer dynamics and lack of awareness to be majorly influencing the tobacco debut and use in youth. Some other important findings emerged such as a lack of available support for tobacco cessation, leading to failure in quitting, a lack of understanding about the ill effects of tobacco and an overall lack of belief in the existing tobacco control measures. The qualitative results were further triangulated by the critical analysis of the national tobacco control policies, comparing them with the WHO Framework Convention on Tobacco Control. Juxtaposition of the qualitative research findings with the policy analysis reveals possible gaps in implementation of the tobacco laws. The findings from this study will inform health policymakers, public health professionals, clinicians, the government and other voluntary organisations to strengthen national tobacco control efforts.

Awareness regarding the adverse effect of tobacco among adults in India: findings from secondary data analysis of Global Adult Tobacco Survey

“…This is further compounded by poor access to drug deaddiction-centres and a lack of stringent implementation of tobacco control measures in rural areas. 5 To overcome the rural–urban disparities and give an impetus to the awareness campaign in rural areas, the Panchayati Raj institutions can provide a platform for awareness campaigns with active participation by local bodies like the Sarpanch and village elderly. Furthermore, the primary healthcare centres can function as the first point of contact for advice and treatment of tobacco addiction by providing specific pharmacotherapeutic and psychosocial interventions to help quit for those seeking help.…”

“… 3 4 The tobacco epidemic is steadily on the rise, affecting LMICs due to a lack of awareness in the population, insufficient health infrastructure and weak regulatory interventions. 5 India is home to 275 million tobacco users and is second only to China in tobacco products. 6 In India, tobacco is responsible for one-tenth (1 million) of all the deaths each year and a significant burden of cancer cases (45% of male’s cancer and 20% of female’s cancer).…”

Evaluation of Perceptions of Tobacco Cessation among the Individuals Attending a Tertiary Care Dental Hospital – A Mixed Methods Design

“…Pattanayak et al, (2012) studied the perceived health risk, and readiness to quit and reported inadequate knowledge, low-risk perception, casual attitude for tobacco-related health risks, and higher perceived ability to quit tobacco was seen among the bipolar disorder patients. Lack of available support for tobacco cessation, leading to failure in quitting, a lack of understanding about the ill effects of tobacco and an overall lack of belief in the existing tobacco control measures were some of the perceptions of tobacco use among the youth of India (Ghose et al, 2019). Delbarre and Aghi (2013) conducted a qualitative study among the vulnerable population of India and France and reported that the study participants anticipated quitting to be extremely challenging, and especially the Indian participants had negative perception towards quitting and believed smokeless tobacco actually improved their health.…”

A public policy analysis with key stakeholders’ insights to understand India’s compliance with the WHO framework convention on tobacco control

“…The number of published policy analysis addressing tobacco control in India is scarce even though there are a significant amount of analyses done in other LMICs such as China [ 17 ] and Brazil [ 18 ], making the need for a policy analysis stronger. We have published previously on the strengths and gaps in the national tobacco policy and contrasted this with the qualitative data obtained from young adult tobacco users [ 19 ]. The goal of the present paper is twofold: a) analyse India’s tobacco control policies considering the WHO-FCTC, identify barriers and gaps, b) reflect on key stakeholders’ perspectives and recommend opportunities for policy reforms.…”