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Smokeless tobacco (SLT) is a global public health concern because it is used in 140 countries.1 The 200 million SLT users in India represent about two-thirds of the global SLT users; India continues to be the leading SLT producer and consumer.2 Every year more than 350 000 people die due to SLT-related diseases in India.3 India ratified the WHO Framework Convention on Tobacco Control (FCTC) and implemented a domestic tobacco control law that prohibited direct and indirect advertising of tobacco products in 2003. However, the SLT industry has continued to circumvent Indian law by finding ways to keep its brands visible by using brand stretching, applying SLT brands to non-tobacco products.
Specifically, brand stretching occurs when a tobacco brand name, emblem, trademark, logo or trade insignia or any other distinctive feature (including distinctive colour combinations) is connected with a non-tobacco product or service in such a way that the tobacco product and the non-tobacco product or service are likely to be associated.
Although in India most SLT products (box 1) are produced and sold in the traditional and informal market (homemade, unregulated, untaxed products sold locally) more than 30% of the market consists of commercially manufactured products.4 The Dharampal Satyapal Limited and Dharampal Premchand Limited companies (popularly known as DS Group) has been in the SLT business in India since 1929, with about 75% of its revenue coming from chewing tobacco and pan masala brands. Its SLT products are marketed domestically in India as well as in the export market.5
SLT products in India
Pan masala: A mixture of areca nut, spices, flavourings and other ingredients.15 16
Areca nut (supari): Seed of the …
Contributors AY conceptualised and developed the first draft. PL and SG contributed to the idea and critically reviewed different versions of the manuscript. All authors contributed to the revision and final manuscript in its present form.
Funding This work was supported by National Cancer Institute grant CA-087472; the funding agency played no role in the conduct of the research or preparation of the manuscript.
Competing interests No, there are no competing interests.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article.