Most forms of tobacco advertising and promotion are prohibited. However, product display at points of sale and unpaid depiction are not prohibited under the law. There are some restrictions on tobacco sponsorship.
There are no restrictions on the sale of single cigarette sticks, small packets of cigarettes, or tobacco products via vending machines or based on location. It is uncertain whether the law prohibits the sale of tobacco products via the internet. The sale of tobacco products is prohibited to persons under the age of 18.
Buy Afghanistan Tobacco
Download Zip: https://miimms.com/2vD9b6
There is substantial variation in tobacco use attributable to demographic factors, such as gender, socioeconomic status, age and migration history within broader racial ethnic or national groups (Global adult tobacco survey 2, 2017). Implicit in the twin studies analyses is the finding that a substantial proportion of the variance in smoking initiation and nicotine dependence is non-genetic, that is, attributable to environmental factors. Nearly all of the environmental factors known to be associated with tobacco use are directly or indirectly influenced by the cultural context (Heath, 1999; Banerjee et al., 2014).
India is the third largest tobacco producing nation and second largest consumer of tobacco world-wide. Mortality due to tobacco in India is estimated at upwards of 1.3 million (Jha, 2008; Sinha, 2014). Global Adult Tobacco Survey (2017) revealed that 28.6 percent (266.8 million) of adults in India aged 15 and above currently use tobacco in some form. In urban areas, khaini (6.8%) and gutka (6.3%) are the two most commonly used tobacco products; whereas in rural areas khaini (13.5%) and bidi (9.3%) are the most prevalent tobacco products (GATS 2, 2017).
Owing to the growing tobacco epidemic, the Government of India began regulatory action towards tobacco control in 2003 with the enactment of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA). India has been one of the earliest nations to ratify the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2004. In 2007-08 India launched its National Tobacco Control Program. By legal provision smoking is completely banned in most public places and workplaces. All forms of tobacco advertising, promotion and sponsorship are prohibited. It is mandatory to have pictorial and text health warning labels on the tobacco product packages
According to the United Nations High Commissioner for Refugees (UNHCR), the second largest group of population of concern, who are not aided by the Government of India, hail from Afghanistan (UNHCR, 2018). While the South Asian Human Rights Documentation Centre (SAHRDC) estimates that approximately 60,000 Afghans live in India (South Asia Human Rights Documentation Centre, 1999). In terms of tobacco use, active cultural retention helps to reinforce traditional cultural ties and the norms regarding smoking and health. As ties to traditional culture weaken through the loss of ethnic culture, smoking patterns may change (Adlaf, 1989; Epstein, 1998; Bachman et al., 2011).
Afghanistan had signed and ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2010. However, according to the 2017 WHO report on the global tobacco epidemic, Afghanistan is lagging in the implementation of most components of MPOWER in comparison to India. The most glaring aspect being the affordability and poor health warning implementation on tobacco products. A standardised packet of 20 cigarettes is 9 times more expensive in India in comparison to Afghanistan. At the same time, Afghanistan lacks a national campaign against tobacco and there is poor fund allocation enforcement of smoke free environment. With no national quit line, it falls short in providing its citizens in providing cessation services (WHO, 2018).
The present cross-sectional study was conducted among adult Afghan tobacco users (in restaurants and cafes), using a self-administered questionnaire. The study was conducted in 3 stages where the first stage involved developing a questionnaire to assess the practices and patterns of tobacco usage among Afghan migrants. A close ended questionnaire was developed, validated and translated in Persian language which is the vernacular for Afghan migrants. This survey underwent a pilot testing procedure with 15 Afghan tobacco users before the implementation of the final study to ensure validity (face) and reliability. As part of this, the surveys were translated (English to Persian) by a language expert and back-translated (Persian to English) for translation reliability. No significant differences in responses were noted between those surveyed in different languages. The questionnaire included questions on socioeconomic status, reason for migration, current and previous tobacco usage patterns and practices. It also included questions on quit attempts, barriers perceived to tobacco use and cessation in India.
Majority of the participants used smoked form of tobacco (70.4%) with 55.9% using cigarettes followed by 13.6% using Naswar (a form of smokeless tobacco popularly used in Afghanistan) as shown in Figure 1. Factors such as peer group (53.3%), stress (36.7%) and staying away from family (6.7%) had reportedly resulted in 21.6% of the participants initiating tobacco use in India.
When assessed for the barriers faced for tobacco use in India most found India to be restrictive to their tobacco use habit and pattern. The results for the same have been represented in Table 2 followed by the barriers faced to quitting tobacco in Table 3. The mean number of quit attempts were 1.85 2.737. The seemingly biggest barrier to tobacco use among Afghan migrants was found to be the cost of the products in India followed by limited or lack of availability of the product of their choice in the Indian market. There was equivocal strength of law enforcements being a barrier to tobacco use. Paucity of social involvement which usually was associated with tobacco use in their home land was also cited as a barrier to tobacco use.
It has been seen that the response of different peoples to the experience of dislocation varies tremendously as does the ability of different social groups to maintain their cultural identity and their traditional social structure and institutions (De Voe DM, 1981; Jayawickreme and Blackie, 2016; Shin, 2017). Social structure and prevailing societal conditions have long been implicated in shaping individual health behaviours including tobacco use practices. Numerous factors culminate into an individual tobacco use practice and pattern including the socio-economic and political policies and situation. While material, social capital, psychosocial factors and prevailing level of health care initiatives affect tobacco use proximally (Bernabé, 2012).
As seen in our study majority of the Afghan tobacco users continued to use the tobacco product they used in their native country, which are not manufactured in India. This puts forth the pertinent question of procuring foreign products by circumventing the laws and regulations under the Cigarette and Other Tobacco Products Act 2003 and articles of FCTC. Such practices act as a threat to tobacco control measures. It would only be understandable that such a phenomenon will not be limited to India but poses as a threat to other countries too. According to the migration profile of Afghanistan, a total of 48,55,068 migrants moved from Afghanistan mostly to Pakistan, Iran, Germany, United Kingdom and United States of America (United Nations Database, 2013). As seen in our study, the regulation on tobacco use acts as a barrier for the migrant group due to higher costs and poorer product availability which are results of stricter implementation of the COTPA and FCTC.
Among our study participants, most participants reported smoking with other fellow Afghans, however our study could not assess the exposure to second hand smoke among this community which owing to the group behaviour of tobacco consumption must be alarming. Since the female populace, is stricken by prejudice and conservatism, it was not possible for us to divulge tobacco use pattern among the women folk of this community. A greater involvement and support of local female leader might prove useful to do the same and penetrate into the community.
Another impending issue brought forth by our study is about the lack of awareness about tobacco cessation services among this group even when most wanted to quit the habit. Majority of the participants did not fear the withdrawal symptoms they might face upon quitting, instead feared losing out on their friends if they quit. This finding is suggestive of the enormous impact the socio-cultural influences have on the initiation and continuation of tobacco use which is in line with context presented by Unger (2003).
Moreover, the results might not directly be generalisable to other countries as the study was conducted exclusively in Delhi. The cross-sectional study design represents a limitation of our data, as a longitudinal assessment would have provided further insight into trends of tobacco use. However, we aimed at prompt availability of the data to claim rapid implementation of corresponding public health interventions.
Introduction: Military service and combat exposure are risk factors for smoking. Although evidence suggests that veterans are interested in tobacco use cessation, little is known about their reasons for quitting, treatment preferences, and perceived barriers to effective tobacco use cessation treatment. Our study objective was to elicit perspectives of Iraq- and Afghanistan-era veterans who had not yet quit smoking postdeployment to inform the development of smoking cessation services for this veteran cohort.
Methods: We conducted 3 focus groups among 20 participants in October 2006 at the Durham Veterans Affairs Medical Center to explore issues on tobacco use and smoking cessation for Iraq- and Afghanistan-era veterans who continued to smoke postdeployment. We used qualitative content analysis to identify major themes and organize data. 2ff7e9595c
Comments