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About the study:

To monitor whether health warnings on smokeless and bidi tobacco products packaging in India being implemented as intended. To investigate variety of packaging and availability of tobacco products. TPackss began with an explanatory and planning phase in 2012 to identify strategic goals and systematic protocols for the project.

Type of study:

Data collection

Timeline:

October 2017 to January 2018

Collaborators:

John Hopkins University (JHU)

Principal Investigator:

Katherine Clegg Smith, Dr. Prakash C. Gupta

Study Participants:

Four types Tobacco Vendors from pan kiosks, tobacco specialists, mobile vendors and small grocery stores.

Data collection

Total 817 tobacco products (bidi and smokeless tobacco (SLT)) were collected from all the five states of India: Assam, Maharashtra, Rajasthan, Karnataka and Uttar Pradesh. From each state, selection of cities/areas (tier 3, 4 and 5), selection of vendors and purchase of products was done using specific protocols.

About the study:

This project was conducted with the to find out the estimates on tobacco use, exposure to second hand smoke, quit attempts among school children across the schools in Mumbai and indirectly measure the impact of tobacco control and prevention initiatives.

Type of study:

School-based case control study designed in schools with children in standards 8th and 9th.

Timeline:

July 2009 to June 2010

Collaborators:

Harvard School of Public Health and Salaam Bombay Foundation

Principal Investigator:

Ms. Padmini Somani, Dr. Prakash C. Gupta (Co-investigator), Dr. Glorian Sorenson (Co-investigator), Prof. K. Viswanath (Co-investigator)

Study Participants:

Children in class 8th and 9th were recruited for the study.

Publications:

About the study:

To monitor whether health warnings on tobacco products are being implemented as intended. To investigate variety of packaging and availability of tobacco products. TPackss began with an explanatory and planning phase in 2012 to identify strategic goals and systematic protocols for the project.

Type of study:

Data collection

Timeline:

October to December 2016

Collaborators:

John Hopkins University (JHU)

Principal Investigator:

Katherine Clegg Smith, Dr. Prakash C. Gupta

Study Participants:

MFour types Tobacco Vendors from pan kiosks, tobacco specialists, mobile vendors and small grocery stores.

Data collection:

Total 287 tobacco products (cigarettes (cigi), bidi and smokeless tobacco (SLT)) were collected from all the four cities. All the tobacco packs were kept in its original packing; two pictures of each packs in the following order were taken at 20 and 180 degrees.

About the study:

The primary focus of the project is to conduct a needs assessment on this particular vulnerable population (pregnant women) from a developing region of the world (Mumbai, India) to determine the most appropriate and efficacious interventions for prenatal and antenatal care within this setting. The overall goal of this project is to develop and assess the feasibility of a behaviour change intervention that integrates evidence-based strategies for both mitigating anaemia due to iron and foliate deficiency, and tobacco cessation into routine ANC services at Primary Health Centres (PHCs). Our specific objective was: Identify barriers and facilitators for optimal delivery and adoption of two behaviour change strategies for anaemia prevention during pregnancy, namely, iron-folic acid supplementation with tobacco use cessation when indicated.

Type of study:

Epidemiological Observational Study

Timeline:

September 1, 2014 to June 30, 2015

Collaborators:

University of Michigan, US

Principal Investigators:

Dr. Mangesh S. Pednekar (Co- Principal Investigator), Dr. Ritesh Mistry, (Co- Principal Investigator), Dr. Andrew Jones (Co- Principal Investigator)

Study Participants:

This observational study was conducted in Mumbai, India at antenatal clinics in 5 PHCs. 100 pregnant women (20 per clinic) were recruited from waiting areas by approaching all patients. Data was collected from April 2015 to April 2016.

Publications:

About the study:

This study was conducted with the primary aim of generating an in-depth understanding of the factors associated with schools’ capability and willingness to adopt a comprehensive tobacco control program.

Type of study:

Randomised Controlled Trial (Pilot study)

Timeline:

April 2014 to March 2015.

Collaborators:

Healis Sekhsaria Institute for Public Health and Harvard School of Public Health

Principal Investigators:

Dr. Prakash C. Gupta, Dr. G.C. Sorensen, Dr. Mangesh. S. Pednekar (Co-investigator), Dr. K. Viswanath (Co-investigator), Dr. Eve M. Nagler (Co-investigator), Dr. Anne M. Stoddard (Co-investigator)

Study Participants:

This was pilot tested in Mumbai, India in Government schools with Grade 8 to 10 from rural and urban area with at least 10 teachers.

About the study:

Maharashtra GYTS survey was conducted to understand the prevalence of tobacco use among school students and the feasibility of conducting GYTS using electronic tablets. It was also done to help understand the effect of tobacco-related laws on its consumption.

Type of Study:

Cross-sectional study

Objectives

  • To document the prevalence of tobacco use among school students of grades 8 to 10.
  • To better understand and assess students’ attitudes, knowledge and behaviors’ related to tobacco use and its health impact, including cessation, environmental smoke, media, and advertising, minors’ access and school curriculum.
  • To understand the awareness about the tobacco-related laws and its effect on tobacco use.
  • To investigate the feasibility of conducting GYTS using electronic tablets in actual field conditions.

Timeline:

May 11, 2012 – June 8, 2012

Collaborators:

Education Department of Maharashtra>

Principal Investigators:

Dr. Prakash C. Gupta, Dr. Mangesh S. Pednekar (Co-investigator)

Study Participants:

School Students 8-10 grade

About the study:

The rationale for formulation of this report was the increased use of smokeless tobacco products, high industry promotion and lack of a realization of the global nature of the problem resulting in poor smokeless tobacco product monitoring and surveillance system, globally. The objectives of the report were to raise the profile of the global challenge posed by smokeless tobacco use, identify sources of information and gaps while also identifying research and policy needs related to smokeless tobacco. This report was prepared based on presentations at the International Smokeless Tobacco Meetings dating back to the year 2002 and onwards.

The National Cancer Institute and Centers for Disease Control and Prevention developed this report under the editorial direction of Prof. Dorothy Hatsukami, Prof. Mitch Zeller, Dr. Prakash C. Gupta, Dr. Mark Parascondola and Dr. Samira Asma .

The report has 15 chapters with topics ranging from regional and worldwide prevalence of smokeless tobacco products, economics of smokeless tobacco and smokeless tobacco regulation and policies. Dr. Prakash C. Gupta provided the editorial oversight and contributed to certain sections of chapters for this report.

This report was released in 2014 at the 3rd National Conference for Tobacco or Health, India, held at Tata Memorial Hospital, Mumbai. It is available online at, https://cancercontrol.cancer.gov/brp/tcrb/global-perspective/index.html

About the study:

This study was done to assess to understand the level of implementation of gutka ban and to understand the effect of gutka ban on tobacco consumption.

Type of study:

The ban was assessed by conducting

Timeline:

December 15, 2012 to July 14, 2013

Collaborators:

Campaign for Tobacco Free Kids (CTFK).

Principal Investigators:

Dr. Prakash C. Gupta, Ms. Gauri Dhumal (Co-investigator)

Study Participants:

Population-based study of current and ex-gutkha users

Place of Study:

The study was conducted in two cities- Mumbai in Maharashtra and Indore in Madhya Pradesh.

Publications:

About the study:

This study was done to assist non-governmental organizations and to undertake legal actions including litigation, where appropriate, to promote the goal of tobacco control, to hold accountable those that violate laws relating to tobacco control and to promote efforts to enforce existing tobacco control laws with providing other legal advice and assistance to promote tobacco control goals in India.

Type of study:

Observational Cross Sectional Study

Timeline:

August 2012- September 2013

Collaborators:

Brihan mumbai Municipal Corporation.

Principal Investigators:

Dr Sharmila Pimple, Dr Surendra S Shastri (Co-Principal investigator), Dr Mangesh S. Pednekar (Co- Principal investigator), Dr Gauravi Mishra (Co- Principal investigator), Ms Parishi Majmudar (Co-investigator) Dr Sandeep Gunjal (Co-investigator)

About the study:

The recommendation for the preparation of a monograph on smokeless tobacco in India came out of a national consultation organized by the Ministry of Health and Family Welfare of India in partnership with the World Health Organisation South East Asia Region (WHO SEARO) and the Public Health Foundation of India (PHFI) in April 4-5, 2011 in New Delhi, with the participation of Healis Sekhsaria Institute for Public Health and the Centers for Disease Control (CDC).

The rationale for the report was that smokeless tobacco has become a major public health concern in India where there are over 200 million users among both males and females; at the same time, globally, smokeless tobacco had increasingly become a public health concern, as cigarette companies had entered into the smokeless tobacco market. Nevertheless, the relevant information could not be obtained at one place. The objectives of the monograph were to build a database of public health evidence on the problem of smokeless tobacco and address information gaps. The report would also identify research needs and recommend policies. It was envisioned as a resource for policy makers.

The concept proposal for the monograph for India was developed at a stakeholders meeting on October, 17, 2011 in New Delhi. The eighteen chapters decided for the monograph were allotted to four different lead agencies, PHFI, Healis, WHO SEARO and CDC to oversee and produce. The chapters allotted to Healis included Marketing, Women, Dual Tobacco Use All-Cause Mortality, Cancer and Health Communications. Healis was requested to coordinate the project and Dr. Prakash Gupta to provide the lead editorial oversight.

Authors were drawn mainly from among experts in India, not limited to those in the lead agencies or stakeholder organizations. At an author’s meeting in New Delhi jointly organized by Healis and the other partners during November 21- 22, 2012, the authors presented the contents of their chapters. The Monograph was released at the planned Endgame Conference in New Delhi, organized by PHFI.

The monograph can be accessed from the following link

http://www.searo.who.int/india/tobacco/smokeless_tobacco_and_public_health_
in_india.pdf?ua=1

About the study:

This study was conducted with the aim to to evaluate perceptions of novel health warnings on smokeless tobacco packages, including various types of warnings (text‐only, symbolic, graphic, and testimonial), among youth and adults.

Type of study:

Descriptive study (Intercept survey)

Timeline:

January 15, 2012 to January 15, 2013

Collaborators:

University of Waterloo, Canada

Principal Investigators:

Dr. David Hammond, Dr. Prakash C. Gupta (Co-investigator)

Study Participants:

Face-to-face interviews were conducted on tablets with adult (19 years and older) smokeless tobacco users and youth (16–18 years) users and non-users in Navi Mumbai (n = 1002), and Dhaka (n = 1081)

Publications:

About the study:

This study was conducted with the aim to analyze the pictorial depictions of health warnings on the packaging and to assess the impact of packaging of cigarettes (brand descriptors, brand imagery, and the potential impact of “plain” packaging).

Type of study:

Descriptive Study

Timeline:

May 2010 to May 2011

Collaborators:

University of Waterloo

Principal Investigators:

Dr. David Hammond, Dr. Prakash C. Gupta (Co-investigator)

Study Participants:

2138 persons were recruited for this study and interviewed using tablets to understand their perceptions on pictorial warnings shown on these tablets.

Publications:

  • Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of an Experimental Study in Four Asian Countries. https://www.ncbi.nlm.nih.gov/pubmed/28767068
  • Perceived effectiveness of text and pictorial health warnings for smokeless tobacco packages in Navi Mumbai, India, and Dhaka, Bangladesh: findings from an experimental study.- https://www.ncbi.nlm.nih.gov/pubmed/26202320

About the study:

This project was conducted with the objective of creating smoke free public places as per section 4 of COTPA and strengthening enforcement and implementation of section-6 of COTPA along with improved monitoring and compliance of Tobacco Control Laws.

Type of study:

Building capacity of decision makers at the State and District level to institutionalize tobacco control within jurisdictions and building capacity of civil society partners at District level.

Timeline:

2010-2011

Collaborators:

International Union against Tuberculosis and Lung Disease (The Union)

Principal Investigator:

Dr. Prakash C. Gupta

Study Participants:

1001 persons were recruited from public areas for this study and interviewed using computer assisted personal interviewing I Pads.

About the study:

This study was conducted to the test the basic comprehension and structure of the updated GYTS Global Core Questionnaire along with some of the optional questions (regional specific) in India using local (Hindi and English) languages.

Type of study:

Group discussion

Timeline:

May 11, 2012 – June 8, 2012

Collaborators:

WHO RSOs working with in-country coordinating staff (as needed) along with collaboration and technical oversight from CDC.

Principal Investigator:

Dr. Prakash C. Gupta

Study Participants:

Students from 8-10 grades of Hindi and English medium groups participated in the discussion.

About the study:

This study was conducted to investigate the effectiveness of the newer pictures, namely X- ray chest depicting lung cancer, scorpion depicting cancer accompanied with the test message stating “Smoking Kills and “Tobacco causes cancer” in the country, to find out whether stronger pictorial warnings have demonstrable public support and to propose newer recommendations for more effective warning labels.

Type of study:

Market Research

Timeline:

October 01, 2009 to August 31, 2010

Collaborators:

Campaign for Tobacco-Free Kids (CTFK)

Publications:

Oswal KC, Raute LJ, Pednekar MS, Gupta PC: Are current tobacco pictorial warnings in India effective? Asian Pac J Cancer Prev. 2011;12(1):121-4.

About the study:

This study was conducted to evaluate “smoke-free Mumbai Campaign” (led by ACT India) by collecting information on compliance of smoke-free laws at public places of Greater Mumbai.

Type of study:

Evaluation Study

Timeline:

March 29, 2009 – December 31, 2012

Collaborators:

ACT India, Mumbai, India

Principal Investigator:

Dr Surendra S Shastri, Dr. Prakash C. Gupta (Co-investigator)

Study Participants:

An Advocacy Project – a Campaign

Place of Study:

Hospitality venues, liquor bars, hookah bars & public transport places (bus/taxi stops).

About the study:

During the year under report, the project was completed.

Timeline:

February 1, 2008 to July 31, 2010

Policy, Media Advocacy & Media Mobilization:

  • Several press conferences, press releases and media interactions to achieve media coverage of important issues in tobacco control were organized.
  • 8 issues of “Tobacco Kills” magazine were published.
  • Meetings with Government Officials such as State Health Ministry, Food and Drug Administration and Brihan Mumbai Municipal Corporation were held.

Website:

Website (aftcindia.org) was developed, maintained and periodically updated.

Collaborators:

The International Union against Tuberculosis and Lung Disease.

Principal Investigator:

Dr. Prakash C. Gupta, Dr. Mangesh S. Pednekar (Co-investigator)

Publications:

http://www.aftcindia.org/press_coverage.htm

Policy Focused Research and Development:

  • 14 Research Studies / Surveys were initiated and one report was compiled from previous surveys.
  • Networking and alliance building activities were undertaken with other tobacco control organizations. Workshops and campaigning were also organized for this purpose. Healis in Mumbai from 23 – 25 June 2010 organized national AFTC Networking Meet. Seventy individuals representing 51 member organizations of the AFTC attended this Meet. Major objective of the networking meet was to bring all the AFTC members under one roof. This was arranged in order to take a collective action for tobacco control, to develop strategies and a plan of action to tackle various issues arising in the implementation of tobacco control policies. Various organizations from throughout India as well as individuals working in different fields ranging from tobacco control advocacy to grassroots tobacco control activism came together on the same platform. This meeting was an important step towards in advancing advocacy and implementation of tobacco control policies in the country.

About the study:

This study was conducted to find out the estimates on tobacco use, exposure to second hand smoke, quit attempts among school children across the schools in Mumbai and indirectly measure the impact of tobacco control and prevention initiatives.

Type of study:

Cross-sectional survey

Timeline:

2010 to 2011

Collaborators:

Fullbright Scholar from University of California, Los Angeles (UCLA)

About the study:

This study was conducted to assess the impact of intervention towards implementing smoke free policies on indoor air quality in hospitality venues.

Type of study:

Prospective study

Timeline:

August 1, 2007 to July 31, 2008

Collaborators:

Roswell Park Cancer Institute, USA

Principal Investigator:

Dr. Prakash Gupta, Dr. Andrew Hyland (Co-investigator), Dr. Dhirendra Sinha (Co-investigator).

Place of Study

Study measured indoor air quality in bars and restaurants (here after referred as Bars), restaurants, country liquor bars, hookah restaurants, and pubs from all over Mumbai.

Publications:

About the study:

This monograph was put together with the aim of providing comprehensive information on consumption patterns, associated risks, laboratory findings, economics and public health policy aspects of bidi use. Although vast amount of literature was available on cigarette use, there was paucity of data on bidi and no available compilation of it. This monograph thus, helped bridge an important gap in the area of public health with detailed information on all aspects of bidi consumption. This monograph was prepared by Healis-Sekhsaria Institute for Public Health in collaboration with the Centers for Disease Control and Prevention, Office on Smoking and Health, USA and with active support from Government of India and World Health Organization.

Dr. Prakash C. Gupta, Director, Healis-Sekhsaria Institute for Public Health and Dr. Samira Asma, Associate Director for Global tobacco Control Program at the Office on Smoking and Health, CDC, were editors of this report.

This monograph has papers, which fall into six broad categories- Product Description, Prevalence of Bidi smoking, Chemistry, Toxicology, Pharmacology and Abuse Potential, Disease Consequences, Economics and Public Health Policy Strategies. The topics discussed under these categories include history, culture, marketing, promotion, availability, laboratory studies, policy implications, and global policy for regulating bidis and bidi smoking.

Intended to be a standard reference on bidis with the goals of encouraging research and promoting policy strategies for regulating bidis, this report was published in the year 2008. It is available as hard copy and also online at https://www.who.int/tobacco/publications/prod_regulation/bidi/en