# Current scenario, challenges and way forward for augmenting tobacco control policies and programs in India: a community-based qualitative study

## TL;DR

This study explores why adolescents in India start using tobacco and how community stakeholders perceive current tobacco control policies, offering recommendations to strengthen these efforts.

## Contribution

The study provides community stakeholder insights and actionable recommendations for improving tobacco control policies targeting youth in India.

## Key findings

- Stakeholders identified gaps in tobacco control policy implementation and recommended stricter enforcement.
- Solutions include modifying health warnings, countering tobacco marketing, and improving school-based anti-tobacco education.
- Multi-sector involvement and better enforcement of tobacco control laws are emphasized for effective tobacco control.

## Abstract

Tobacco use has resulted in a staggering number of illnesses and premature deaths worldwide. India has the world’s second-highest level of tobacco consumption. The study aimed to explore the reasons of initiation among adolescents and understand community stakeholders’ perceptions about the current tobacco control policies and challenges faced in implementing it for youth along with future recommendations.

Focus Group Discussions (FGDs) were conducted with adolescents in grades 7th–9th, teachers, parents, and police officers, along with in-depth interviews (IDI) with tobacco vendors. These were digitally audio-recorded and transcribed verbatim. Data was analyzed using inductive thematic analysis.

Twenty-two focus groups were conducted with adolescents, 10 with parents, 10 with teachers (n = 83), 5 with police (n = 42) and 10 tobacco vendors completed one-to-one interviews. Stakeholders identified gaps in tobacco control policy implementation and recommended stricter enforcement. Solutions such as modifying on-screen health warnings, developing novel ways like live demonstration of patients suffering from tobacco use which creates awareness about tobacco harms, countering tobacco industry marketing strategies, restricting tobacco product sales, lowering affordability, and prominently displaying tobacco-free film rules were recommended.

The study provides a thorough understanding of factors that lead to tobacco initiation and stakeholder’s opinion on youth-related tobacco legislation that provides direction for strengthening existing tobacco control efforts. There is a need for novel ways to educate the child’s microenvironment, specifically in school and family environment. The findings also emphasize the importance of multi-sector involvement and better enforcement of tobacco control laws.

Main findings: Strengthen the existing tobacco control initiatives like strict adherence to tobacco-free film and television guidelines, enhanced media advocacy campaigns and policy emphasizing greater emphasis on child’s micro environment.Added Knowledge: The current study provides perception of community-level stakeholders and emphasize the need for committed multi-sector involvement for implementing the tobacco control laws and improvising the school-based anti-tobacco education.Global health impact for policy and action: This article provides evidence to reform the existing tobacco control laws and galvanize the implementation of these laws to further reduce tobacco use and move towards a tobacco-free generation.

Main findings: Strengthen the existing tobacco control initiatives like strict adherence to tobacco-free film and television guidelines, enhanced media advocacy campaigns and policy emphasizing greater emphasis on child’s micro environment.

Added Knowledge: The current study provides perception of community-level stakeholders and emphasize the need for committed multi-sector involvement for implementing the tobacco control laws and improvising the school-based anti-tobacco education.

Global health impact for policy and action: This article provides evidence to reform the existing tobacco control laws and galvanize the implementation of these laws to further reduce tobacco use and move towards a tobacco-free generation.