Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions
Introduction Approximately 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 kh...
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| Format: | Article |
| Language: | English |
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European Publishing
2025-06-01
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| Series: | Tobacco Induced Diseases |
| Subjects: | |
| Online Access: | https://www.tobaccoinduceddiseases.org/Standardizing-smokeless-tobacco-packs-in-India-to-enhance-health-warning-visibility,205097,0,2.html |
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| author | Hannah E. Barker Raniyan Zaman Lauren Czaplicki Sejal Saraf Rana J. Singh Ashish K. Pandey Joanna E. Cohen |
| author_facet | Hannah E. Barker Raniyan Zaman Lauren Czaplicki Sejal Saraf Rana J. Singh Ashish K. Pandey Joanna E. Cohen |
| author_sort | Hannah E. Barker |
| collection | DOAJ |
| description | Introduction
Approximately 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.
Methods
In 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.
Results
All 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.
Conclusions
Both 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. |
| format | Article |
| id | doaj-art-2edc3defc7de4a3c9dc16d3de5643d49 |
| institution | DOAJ |
| issn | 1617-9625 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | European Publishing |
| record_format | Article |
| series | Tobacco Induced Diseases |
| spelling | doaj-art-2edc3defc7de4a3c9dc16d3de5643d492025-08-20T03:15:31ZengEuropean PublishingTobacco Induced Diseases1617-96252025-06-0123June11310.18332/tid/205097205097Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptionsHannah E. Barker0https://orcid.org/0000-0002-0405-2209Raniyan Zaman1https://orcid.org/0009-0007-7852-839XLauren Czaplicki2https://orcid.org/0000-0002-7496-0990Sejal Saraf3https://orcid.org/0000-0001-9109-8143Rana J. Singh4https://orcid.org/0009-0000-6459-5873Ashish K. Pandey5https://orcid.org/0009-0002-8234-1628Joanna E. Cohen6https://orcid.org/0000-0002-3869-3637Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, United StatesInstitute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, United StatesInstitute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, United StatesInstitute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, United StatesVital Strategies Tobacco Control Division, New Delhi, IndiaVital Strategies Tobacco Control Division, New York, United StatesInstitute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, United StatesIntroduction Approximately 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. Methods In 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. Results All 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. Conclusions Both 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.https://www.tobaccoinduceddiseases.org/Standardizing-smokeless-tobacco-packs-in-India-to-enhance-health-warning-visibility,205097,0,2.htmlpolicysmokeless tobaccohealth warning labeltobacco packagingindia |
| spellingShingle | Hannah E. Barker Raniyan Zaman Lauren Czaplicki Sejal Saraf Rana J. Singh Ashish K. Pandey Joanna E. Cohen Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions Tobacco Induced Diseases policy smokeless tobacco health warning label tobacco packaging india |
| title | Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions |
| title_full | Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions |
| title_fullStr | Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions |
| title_full_unstemmed | Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions |
| title_short | Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions |
| title_sort | standardizing smokeless tobacco packs in india to enhance health warning visibility and harm perceptions |
| topic | policy smokeless tobacco health warning label tobacco packaging india |
| url | https://www.tobaccoinduceddiseases.org/Standardizing-smokeless-tobacco-packs-in-India-to-enhance-health-warning-visibility,205097,0,2.html |
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