ORCID Profile
0000-0001-9987-3933
Current Organisations
All India Institute of Medical Sciences
,
Public Health Foundation of India
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Publisher: SAGE Publications
Date: 05-2020
Abstract: In India, there has been no attempt to measure the implementation of World Health Organization’s Framework Convention on Tobacco Control Article 5.3, which provides guidelines to address tobacco industry interference (TII). This study draws on a desk review conducted to assess the frequency and severity of TIIs and the government’s response, reported between January and December 2017. This study highlights that the government of India does not allow tobacco industry to participate in policy development. However, the industry interferes by collaborating with the government’s allied organizations. The tobacco industry has ersified as food industry in India, and directly or indirectly supports various government programs, by investing through their corporate social responsibility schemes. In addition, there are limited legislative measures to allow transparency in adoption of Article 5.3 guidelines across the country. Hence, the findings of this study underscore an exigent need to adopt and implement Article 5.3 at the national level in India.
Publisher: Elsevier BV
Date: 06-2018
Publisher: Elsevier BV
Date: 06-2022
Publisher: Ubiquity Press, Ltd.
Date: 07-2012
DOI: 10.1016/J.GHEART.2012.06.005
Abstract: Critical to health promotion is surveillance of tobacco use that is a leading risk factor for cardiovascular diseases (CVDs). The objective of this paper is to analyze information from global tobacco surveys as relevant for CVD prevention and, hence, for cardiologists implying their role in clinical and policy settings for advancing tobacco control. This article uses MPOWER strategy as a framework to discuss information available from The Global Tobacco Surveillance System (GTSS) established in 1998. Data underline the need for cardiologists to 1) step up their efforts in promoting and providing cessation services in clinical settings 2) become tobacco control advocates and support policy implementation in their countries 3) raise patient and community awareness of harm caused by tobacco use and SHS exposure to health 4) undertake policy relevant research where required and 5) support national governments in effective implementation of provisions of the Framework Convention on Tobacco Control (FCTC).
Publisher: Springer Science and Business Media LLC
Date: 25-01-2021
DOI: 10.1186/S12992-021-00660-0
Abstract: Efforts to adopt public health policies that would limit the consumption of unhealthy commodities, such as tobacco, alcohol and ultra-processed food products, are often undermined by private sector actors whose profits depend on the sales of such products. There is le evidence showing that these corporations not only try to influence public health policy they also shape research, practice and public opinion. Globalization, trade and investment agreements, and privatization, amongst other factors, have facilitated the growing influence of private sector actors on public health at both national and global levels. Protecting and promoting public health from the undue influence of private sector actors is thus an urgent task. With this backdrop in mind, we launched the “Governance, Ethics, and Conflicts of Interest in Public Health” Network (GECI-PH Network) in 2018. Our network seeks to share, collate, promote and foster knowledge on governance, ethical, and conflicts of interest that arise in the interactions between private sectors actors and those in public health, and within multi-stakeholder mechanisms where iding lines between different actors are often blurred. We call for strong guidance to address and manage the influence of private sector actors on public health policy, research and practice, and for dialogue on this important topic. Our network recently reached 119 members. Membership is erse in composition and expertise, location, and institutions. We invite colleagues with a common interest to join our network.
Publisher: Springer Science and Business Media LLC
Date: 04-04-2017
Publisher: Elsevier BV
Date: 06-2016
Publisher: Elsevier BV
Date: 12-2014
Publisher: E.U. European Publishing
Date: 14-12-2021
DOI: 10.18332/TID/143179
Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJOPEN-2020-042860
Abstract: Smokeless tobacco (ST) was consumed by 356 million people globally in 2017. Recent evidence shows that ST consumption is responsible for an estimated 652 494 all-cause deaths across the globe annually. The WHO Framework Convention on Tobacco Control (FCTC) was negotiated in 2003 and ratified in 2005 to implement effective tobacco control measures. While the policy measures enacted through various tobacco control laws have been effective in reducing the incidence and prevalence of smoking, the impact of ST-related policies (within WHO FCTC and beyond) on ST use is under-researched and not collated. A systematic review will be conducted to collate all available ST-related policies implemented across various countries and assess their impact on ST use. The following databases will be searched: Medline, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Scopus, EconLit, ISI Web of Science, Cochrane Library (CENTRAL), African Index Medicus, LILACS, Scientific Electronic Library Online, Index Medicus for the Eastern Mediterranean Region, Index Medicus for South-East Asia Region, Western Pacific Region Index Medicus and WHO Library Database, as well as Google search engine and country-specific government websites. All ST-related policy documents (FCTC and non-FCTC) will be included. Results will be limited to literature published since 2005 in English and regional languages (Bengali, Hindi and Urdu). Two reviewers will independently employ two-stage screening to determine inclusion. The Effective Public Health Practice Project’s ‘Quality Assessment Tool for Quantitative Studies’ will be used to record ratings of quality and risk of bias among studies selected for inclusion. Data will be extracted using a standardised form. Meta-analysis and narrative synthesis will be used. Permission for ethics exemption of the review was obtained from the Centre for Chronic Disease Control’s Institutional Ethics Committee, India (CCDC_IEC_06_2020 dated 16 April 2020). The results will be disseminated through publications in a peer-reviewed journal and will be presented in national and international conferences. CRD42020191946.
Publisher: SAGE Publications
Date: 28-03-2021
DOI: 10.1177/00178969211005499
Abstract: The purpose of this study was to assess the experience and satisfaction of teachers and parents of children with and without diabetes, with the Kids and Diabetes in School (KiDS) intervention. Project KiDS aimed to foster a safe and supportive school environment to encourage the management of type 1 diabetes and prevention of type 2 diabetes. This qualitative evaluation involved semi-structured, face-to-face, in-depth interviews with a purposive s le of 35 respondents, including teachers and parents of children with and without diabetes attending the selected schools at 1 and 3 months post-intervention implementation. In total, n = 5 schools (3 government and 2 private) were selected out of 15 schools in which the KiDS project was implemented. In total, 65 interviews were conducted in two rounds. The s le comprised teachers ( n = 20 in round 1 n = 18 in round 2), parents of children with diabetes ( n = 3 in both the rounds) and parents of children without diabetes ( n = 15 in round 1 n = 6 in round 2) attending five schools. Data were analysed using the thematic framework method. Teachers reported gaining new knowledge as a result of the KiDS intervention. They felt more confident in assisting children with diabetes. Suggestions to strengthen the KiDS resource pack were the inclusion of case studies and audio-visual aids. Parents of children with diabetes reported that the project reinforced information and improved diabetes management skills. Their suggestions for strengthening KiDS materials included the provision of additional technical information. The parents of children without diabetes reported that the resource pack aided a better understanding of diabetes and clarified myths and misconceptions. Suggestions for strengthening the pack included the regular reinforcement of information on diabetes among children. Findings support the upscaling of KiDS work elsewhere in India through the engagement of multiple stakeholders to promote the management and prevention of diabetes in school.
Publisher: Elsevier BV
Date: 06-2016
Publisher: Frontiers Media SA
Date: 07-10-2020
Publisher: Elsevier BV
Date: 06-2021
Publisher: Oxford University Press (OUP)
Date: 04-10-2022
DOI: 10.1093/NTR/NTAC230
Abstract: We studied the change in affordability of tobacco products, an important determinant of tobacco use, across the different socio-economic status (SES) in India. We calculated affordability in the form of relative income price (RIP-cost of tobacco products relative to income) for years 2011-12 and 2018-19 using three different denominators, i.e., per capita Gross Domestic Product (GDP) and Net State Domestic Product (NSDP) at national and state levels, respectively monthly per capita consumer expenditure (MPCE) and in idual wages. We investigated RIP for cigarettes, bidis and smokeless tobacco (SLT) across different SES groups (caste groups, type of employment and education). RIP increased marginally for cigarettes, bidis and remained almost constant for SLT across casual workers. However, when RIP was adjusted with SES variables, there was no significant change (p>0.05) in affordability of products for casual workers in year 2018-19 as compared to 2011-12. For regular workers, cigarettes and bidis became marginally less affordable (β<1), whereas affordability remained constant for SLT. All products became more affordable for backward caste groups within regular workers. When RIP was calculated using MPCE all tobacco products became less affordable in year 2018-19. However, after adjusting for SES variables SLT reported no change in affordability. There was a marginal increase in affordability for all products when RIP was calculated with GDP. Although implementation of GST has increased the price of tobacco products, it is still not sufficient to reduce the affordability of tobacco products, particularly SLT and especially for the lower SES group. Tobacco use and economic disadvantage conditions of population are intricately linked. Affordability of tobacco products is influenced by socio-economic indicators like age, sex, income, education, etc. The literature measuring the affordability of tobacco products across different SES groups is scant in India. Additionally, existing literature measures affordability of tobacco products based on per capita GDP as a proxy for income. This is the first study in Indian context to report the change in affordability of tobacco products across different SES groups after adjusting for SES indicators, using in idual level income data. We have calculated the change in affordability of tobacco products between year 2011-12 and 2018-19 using GDP, household income, and in idual wages as proxy for income.
Publisher: Springer New York
Date: 2013
Publisher: Public Library of Science (PLoS)
Date: 18-04-2019
Publisher: Wiley
Date: 03-06-2015
Publisher: E.U. European Publishing
Date: 10-2019
DOI: 10.18332/TID/110677
Publisher: BMJ
Date: 08-09-2020
DOI: 10.1136/TOBACCOCONTROL-2019-055353
Abstract: Exposure to smoking in films is a recognised cause of smoking uptake among children. In India, in an attempt to protect children, films containing smoking are required to include tobacco control messaging including audiovisual disclaimers, on-screen health warnings when tobacco imagery is displayed and antitobacco ‘health spots’ before and during the film. We report a study of the association between ever smoking and exposure to tobacco imagery in locally popular films among children in Udupi district of Karnataka state in southern India. A cross-sectional questionnaire survey of all students in grades 6–8 in schools in the Udupi district ascertained smoking status and potential confounders of smoking uptake, and whether children had seen any of 27 locally popular films we had coded and found to contain imagery of actual or implied tobacco use. Ever-smoking status was defined as any reported smoking of cigarettes, beedis or other tobacco products currently or at any time in the past. Independent effects on ever-smoking status were estimated using multiple logistic regression. Of 46 706 students enrolled in grades 6–8 in 914 participating schools, 39 282 (84.1%) provided questionnaire responses sufficiently complete for analysis. Ever smoking was reported by 914 (2.3%) participants and in a mutually adjusted model was significantly related to age, male sex, living in a home where smoking is allowed, having parents or siblings who smoke, low paternal education, low levels of family wealth, low self-esteem, rebelliousness and poor school performance. After allowing for these effects, the odds of ever smoking were not increased among students who had seen any of the listed films containing tobacco imagery when included in the analysis as a binary exposure (OR 0.9, 95% CI 0.4 to 2.0), and decreased in relation to level of exposure graded into tertiles of tobacco intervals seen. In this cross-sectional study, children in southern India who had seen films containing tobacco imagery are no more likely to smoke than those who had not, indicating that the tobacco control messaging mandated by Indian law may be attenuating the effect of tobacco imagery in films on smoking uptake.
Publisher: Ubiquity Press, Ltd.
Date: 2022
DOI: 10.5334/GH.1132
Publisher: BMJ
Date: 09-02-2022
DOI: 10.1136/TOBACCOCONTROL-2021-057119
Abstract: In federal systems, state and local governments may offer opportunities for innovation in implementing the WHO Framework Convention on Tobacco Control (FCTC). This paper explores the implementation of WHO FCTC Article 5.3 within India’s federal system, examining how its guidelines have been operationalised across states and union territories. Interviews with officials from government and civil society organisations across key states, and a document review of state government and district administration notifications adopting Article 5.3 guidelines between 2015 and 2019. The data reveal subnational leadership in formulating intersectoral committees, which are designed to limit interactions with the tobacco industry, and corresponding measures to reject partnership and conflicts of interest for government officials. There are notable omissions across states and union territories in adoption of key Article 5.3 guidelines only four districts and state governments refer to regulating aspects of ‘socially responsible’ industry activities, and no notifications include measures to prevent the tobacco industry receiving preferential treatment or requiring that information provided by industry actors be transparent and accountable. Interview data indicate that dynamics of notification across states have been shaped by lesson drawing and the catalytic role of civil society. The adoption of protocols is impacting on the practices of health officials, but there are concerns about engagement by other departments and the regulatory capacity of empowered committees. The spread of state- and district-level policies illustrates opportunities federal structures can provide for accelerating tobacco control. Given significant omissions and policy tensions, there remains a need for national action to build on these innovations, including in revisions to India’s tobacco control legislation.
Publisher: BMJ
Date: 06-2020
DOI: 10.1136/BMJOPEN-2019-033178
Abstract: This study aims to quantify the extent to which people’s use of tobacco products varies by local areas (city ward and village) across India and the variation in this clustering by tobacco products. Cross-sectional study. Data on 73 954 adults across 2547 city wards and villages were available for analysis from 30 states and 2 union territories in India. We included as primary outcomes self-reported any tobacco use, current cigarette smoking, current bidi smoking, current smokeless tobacco use and a derived variable for dual use describing respondents who engaged in both smoking and smokeless tobacco use. The median risk of an in idual using tobacco was 1.64 times greater if a person hypothetically moved from an area of low to high risk of tobacco use (95% CI: 1.60 to 1.69). Area-level partitioning of variation differed by tobacco product used. Median ORs ranged from 1.77 for smokeless tobacco use to 2.53 for dual use. Tobacco use is highly clustered geographically in India. To be effective in India, policy interventions should be directed to influence specific local contextual factors on adult tobacco use. Where people live in India influences their use of tobacco, and this association may be greater than has been observed in other settings. Tailoring tobacco control policies for local areas in India may, therefore, provide substantial public health benefits.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Frontiers Media SA
Date: 2013
Publisher: BMJ
Date: 26-07-2021
DOI: 10.1136/TOBACCOCONTROL-2021-056629
Abstract: India’s tobacco-free film and TV rules were implemented from 2012. To assess the effect of the rules, we studied tobacco depictions in top-grossing Bollywood films released between 2006 and 2017 and rule compliance after 2012. Tobacco incidents and brand appearances were coded in 240 top-grossing Bollywood films (2006–2017) using the Breathe California method. Trends in number of tobacco incidents per film per year were studied before and after implementation of the rules using Poisson regression analysis. Compliance with rules over the years was studied using Pearson product-moment correlations. Forty-five films were U-rated (all ages), 162 were UA-rated (below age 12 years must be adult-accompanied), and 33 were A-rated (age 18+ years only). Before implementation of the rules, the number of tobacco incidents per film was increasing by a factor of 1.1/year (95% CI 1.0 to 1.2, p=0.002). However, beginning year 2013, the number of incidents per film started falling significantly by a factor of 0.7/year (95% CI 0.6 to 0.9 p=0.012) compared with the previous increasing trend. The percentage of youth-rated (U and UA) films with any tobacco incidents also declined from a peak of 76% in 2012 to 35% in 2017. The percentage of films complying with the rules (audio-visual disclaimers, health spots, static warnings) did not change significantly from 2012 to 2017. India’s 2012 rules were followed by a reduction in tobacco depictions in Bollywood films. Enhanced monitoring of compliance is needed to ensure the continued effectiveness of the rules.
Publisher: Ubiquity Press, Ltd.
Date: 06-2015
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/837804
Abstract: Socioeconomic differences in tobacco use have been reported, but there is a lack of evidence on how they vary according to types of tobacco use. This study explored socioeconomic differences associated with cigarette, bidi, smokeless tobacco (SLT), and dual use (smoking and smokeless tobacco use) in India and tested whether these differences vary by gender and residential area. Secondary analysis of Global Adult Tobacco Survey (GATS) 2009-10 ( n = 69 , 296 ) was conducted. The primary outcomes were self-reported cigarette, bidi smoking, SLT, and dual use. The main explanatory variables were wealth, education, and occupation. Associations were assessed using multinomial logistic regressions. 69,030 adults participated in the study. Positive association was observed between wealth and prevalence of cigarette smoking while inverse associations were observed for bidi smoking, SLT, and dual use after adjustment for potential confounders. Inverse associations with education were observed for all four types after adjusting for confounders. Significant interactions were observed for gender and area in the association between cigarette, bidi, and smokeless tobacco use with wealth and education. The probability of cigarette smoking was higher for wealthier in iduals while the probability of bidi smoking, smokeless tobacco use, and dual use was higher for those with lesser wealth and education.
Publisher: BMJ
Date: 09-04-2020
DOI: 10.1136/TOBACCOCONTROL-2019-055360
Abstract: India implemented tobacco-free film and TV rules (Rules) to protect adolescents and young adults from tobacco exposure. To assess tobacco imagery in online series popular among adolescents and young adults. Ten popular online series on streaming platforms were identified after discussions with participants (aged 15–24 years) in New Delhi, and content-coded for tobacco imagery following the Breathe California protocol. Incidents of tobacco use and brand appearances in each series episode were counted, and compliance with Indian Rules was recorded. 188 episodes across 10 series on Netflix and Amazon Prime Video were coded. Seven series were rated age 16+, two were 18+ and one was 13+. The median number of tobacco incidents per episode in foreign productions was as follows: Amazon’s ‘The Marvellous Mrs Maisel’ (87.5, IQR 62.0–116.0) and Netflix’s ‘The Crown’ (29.0, 18.0–36.0) were higher than Indian productions: Netflix’s ‘Sacred Games’ (9.0, 0.5–14.5) and Amazon’s ‘Mirzapur’ (7.0, 4.0–11.0) (p=0.84). Tobacco incidents per hour ranged from 0 (Bodyguard, Riverdale, 13 Reasons Why) to 106.1 (The Marvellous Mrs Maisel). Seven of 10 series had tobacco imagery and none were compliant with the Rules. Contrary to Section 5 of India’s Cigarettes and Other Tobacco Products Act, its Rules are not being complied with by the streaming platforms. US-produced streaming media contains more tobacco incidents than Indian-produced media. There is an urgent need for better enforcement of existing Rules on streaming platforms in India, and modernisation of the WHO Framework Convention on Tobacco Control, Article 13 guidelines to account for new streaming platforms to protect youth from tobacco imagery globally.
No related grants have been discovered for monika arora.