RT Journal Article
SR Electronic
T1 Smokeless tobacco products, supply chain and retailers’ practices in England: a multimethods study to inform policy
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP e45
OP e49
DO 10.1136/tobaccocontrol-2020-055830
VO 30
IS e1
A1 Faraz Siddiqui
A1 Talib Khan
A1 Anne Readshaw
A1 Ray Croucher
A1 Martin Dockrell
A1 Cath Jackson
A1 Mona Kanaan
A1 Jim McCambridge
A1 Ann McNeill
A1 Steve Parrott
A1 Aziz Sheikh
A1 Kamran Siddiqi
YR 2021
UL http://tobaccocontrol.bmj.com/content/30/e1/e45.abstract
AB Background In England, many people of South Asian origin consume smokeless tobacco (ST). ST use can lead to oral cancer, which is disproportionately high in South Asians. Our aims were to assess the compliance of ST product retailers with statutory regulations and to explore the supply chain of ST.Methods We undertook a multimethods study between August 2017 and July 2019 in five English boroughs with a high proportion of ethnic South Asians. We purchased ST products and conducted field surveys with ST retailers at point of sale. Qualitative interviews were conducted with ST retailers and suppliers. ST packs were assessed for regulatory compliance, while quantitative and qualitative data triangulated information on retailers’ practices and the ST supply chain.Results We collected 41 unique ST products, which included dry snuff, naswar, gutka, chewing tobacco and zarda. ST products were not registered, and demonstrated low compliance with health warning (14.6%) and packaging (56.1%) requirements. ST availability in surveyed boroughs was high (38.2%–69.7%); dry snuff, naswar and zarda were most commonly available. ST retailers demonstrated limited knowledge of regulations, and one-third were found to advertise ST at point of sale. Qualitative insights revealed illicit supply and distribution networks, as well as ST production in discreet locations.Conclusion ST products are widely available in England, yet non-compliant with statutory regulations. In order to safeguard consumers, in particular ethnic South Asians, stronger efforts are needed to regulate the supply chain of ST at both national and international levels.