Perception of young adults toward hookah use in Mumbai.

BACKGROUND: The use of tobacco has been on the rise globally including in India, posing a grave public health problem. Recently, tobacco use through hookah smoking has increased among young adults in India, Middle East, Southwest Asia, Africa, Europe and North America. Hookah prevalence of 0.4‑15% has been reported in India. AIM: The aim of the study was to understand perception of hookah use among young adults in Mumbai. MATERIALS AND METHODS: A total of 500 college students, with/without hookah habit, were given a self‑administered questionnaire to indicate their perception of hookah use, using yes/no responses. The responses were analyzed in the users/non‑users and considered significantly different at P < 0.05. RESULTS: Responses were received from 122 hookah users and 325 non‑users. The perception of hookah use between users and non‑users and males and females, showed significant differences (P < 0.05), with respect to hookah being injurious to health, causes cancer, is addictive, influence of a close friend, flavors, curiosity toward hookah use and willingness to prepare hookah at home. Whereas, differences in the groups perception of hookah as safer than cigarettes, harmful air quality, ambience, cool look and means of socializing, was not observed. CONCLUSION: The perception of young adults in Mumbai, toward hookah use, indicates an increased trend to use hookah. We recommend deterrents for hookah use by display of health warnings on hookah assembly and the tobacco products, implementation of government policies on hookah and tobacco use and punitive measures for offenders.

Tobacco industry tactics with advertisements at the point of sale in Mumbai.

INTRODUCTION: The Cigarettes and Other Tobacco Products (Prohibition of Advertising and Regulations of Trade and Commerce, Production, Supply and Distribution) Act 2003 (COTPA) set out a number of stringent regulations to address tobacco promotion, some of which were revised in 2004. The aim of the study was to monitor the industry tactics at the point of sale with advertising and promotion of tobacco product in Mumbai. MATERIALS AND METHODS: The study was carried out by Cancer Patients Aid Association in Mumbai with the help of volunteers. The surveys consisted of two parts, observational information and an interviewer administered questionnaire. Observations like size of board, display of advertisement, backlighting, and use of any promotion were noted. A questionnaire captured information about any incentives from tobacco companies for advertisement and promotion was administered to the vendors who agreed to participate. Study was approved by the Scientific and independent Ethics committee. RESULTS: Total 125 establishments (58 shops, 55 kiosks, 12 other sites) with display boards were surveyed across 5 wards in Mumbai. It was noted that the most common violation was the placements of boards, mainly placed above the shop. The display boards were oversized and few of the advertisements were highlighted with backlights. Out of 125 tobacco vendors surveyed, 107 (85.5%) vendors agreed to answer the questionnaire. We noted that a majority of 67% (84 vendors) stated that they had been approached by tobacco companies to place the signages during the past 5 years post COTPA came into effect. 79 vendors (65 %) admitted to being paid by the tobacco companies. DISCUSSION: Although the civil society and various non-governmental organizations has casted voice against the industry tactics but ineffective enforcement of the law is a major hurdle. It is likely that cigarette companies will be further able to overcome advertising restrictions by finding loopholes in tobacco legislation unless the decision makers ban it comprehensively as evident in other countries.

Study on tobacco use and awareness among marginalized children.

Background : The current study entailed a survey of children from the lower socioeconomic strata of rural and urban regions of the states of Maharashtra and Assam who are vulnerable to tobacco usage. More than 1700 children were checked for precancerous lesions and 1004 were surveyed for tobacco habits and awareness. Aims: The objective of the survey was to determine and report on all the variant factors affecting the use of tobacco among the underprivileged children population. The aim of the clinical check-up was to detect precancerous lesions in the tobacco-using children at an early treatable stage. Materials and Methods : Awareness lectures and ENT camps were conducted at 12 organizations/community centers. A cross-section of children were interviewed to understand tobacco use among them. All the children were screened for precancerous lesions. Children with suspicious oral lesions were sent for further evaluation at a nearby diagnostic cancer facility. The survey was conducted by trained social workers. Results : The percentage of tobacco users in urban Mumbai was quite low at 4.8% compared with rural Kasara (36%) and Assam (76%); and 74.6% of the children were aware that tobacco use was dangerous and harmful to health. The average age of initiation was 9 years. Out of the 1004 children surveyed, 253 were tobacco users and 79% were males. Of the 1700 children screened, 23.5% presented with precancerous oral lesions. Conclusion : This study addresses the tobacco habits of a typical sample of marginalized children in India and the need for effective interventions aiming at reducing the burden of tobacco-related cancers by controlling at the point of initiation.