ITC India Pilot Survey Maansi Bansal-Travers, Ph.D. Department of Health Behavior Roswell Park Cancer Institute ITC-TTURC Project Annual Meeting Portland,

ITC India Pilot Survey

Maansi Bansal-Travers, Ph.D.Department of Health BehaviorRoswell Park Cancer Institute

ITC-TTURC Project Annual MeetingPortland, Oregon—March 1, 2008

India: Demographics

Population Over 1.1 BillionAdults (>15 years) 67.9%Urban 29.0%Growth rate 1.7%

Income Group LowIncome per capita (Intl $) $3,460Extreme Poverty Rate 34.7%Literacy Rate 61.0%

India: Prevalence

Males 17.3% Females 9.7% Overall 14.1%

Youth Prevalence (2006 GYTS national sample, 13-15 years)

Males 32.7% Females 1.4%

Overalldata not available

Adult Prevalence (current cigarette use, 2005)

India: Tobacco Industry

Cigarette Production 90 BillionCigarette Imports 200 MillionCigarette Exports 1.5 Billion

Tobacco Industry(From Tobacco Atlas, 2006)

India: FCTC Status

Signed 10 Sept 2003 Ratified 5 Feb 2004

FCTC Status

India: FCTC—Price and Taxation

In National Currency 68.00 INRUSD $1.50

In International $ $7.04Affordability of most popular brand: % of annual per capita

income required to buy 100 packs

20%

Taxes~57% of

retail price

Cigarette Price of most popular brand

India: FCTC—Non-Price Measures

Advertising/Promotion Bans

Fairly comprehensive except for point of sale

Enforcement Rating 7/10

Warning Labels FCTC min50% of principal display areaPictorial warning implementation delayed

Smoke-Free YesExcept restaurantsEnforcement Rating 2/10

ITC India Pilot Survey

• Conducted in Maharashtra (n=337) and Bihar (n=427)

• Each area was broken down into Urban and Rural geographic regions

• Survey instrument was translated into Hindi, Marathi, and a few other languages

Demographics

n %

Mean Age=42

Sex

Male 460 60%

Female 304 40%

Region

Urban 282 37%

Rural 482 63%

Overall Health

Poor 4 1%

Less poor 15 2%

Good 92 12%

Very good 316 41%

Excellent 333 44%

n %

Education level

Illiterate 291 38%

Primary 106 14%

Middle 128 17%

Secondary 128 17%

College 97 13%

Above 11 1%

Tobacco Use

Smoker 249 33%

Smokeless 248 32%

Non-tobacco user 267 35%

Health concerns

• Do you think smokeless tobacco use is good for your health?– Good: 61 (8%)– Neither good nor bad: 78 (10%)– Not good: 616 (81%)

• Do you think smoking is good for your health?– Good: 61 (8%)– Neither good nor bad: 48 (6%)– Not good 649 (85%)

• To what extent, if at all, has smoking damaged your health?– Not at all: 251 (51%)– A little: 168 (34%)– Very much: 11 (2%)– Don’t know: 60 (12%)

Health concerns

• [Among smokers] In the last month, have you butted out a cigarette or bidi before you finished it because you thought about the harm of smoking?– Yes: 41 (16%)– No: 195 (78%)

• If you had to do it over again, you would not have started using tobacco.– Agree: 213 (43%)– Neither agree nor disagree: 23 (5%)– Disagree: 186 (37%)

• Have you ever tried to stop smoking?– Yes: 139 (28%)– No: 357 (72%)

Beliefs about health effects and SLT

% Yes

Mouth cancer 74%

Gum disease 60%

Difficult to open mouth 49%

Beliefs about health effects and smoking

% Yes

Stroke 25%

Impotence 26%

Lung cancer 70%

Mouth cancer 44%

Stained teeth 44%

Premature aging 68%

Lung cancer in nonsmokers from SHS

45%

Coronary heart disease 26%

Cigarettes vs. Bidis

• Compared to smoking cigarettes, do you think bidis are less harmful, more harmful, or no different for health?– Bidis less harmful: 17%– Bidis more harmful: 22%– No difference: 47%– DK: 14%

Cigarettes vs. SLT

• Compared to smoking cigarettes, do you think smokeless tobacco products are less harmful, more harmful, or no different for health?– SLT less harmful: 23%– SLT more harmful: 15%– No difference: 48%– DK: 14%

Bidis vs. SLT

• Compared to smoking bidis, do you think smokeless tobacco products are less harmful, more harmful, or no different for health?– SLT less harmful: 21%– SLT more harmful: 17%– No difference: 48%– DK: 14%

Health Warnings

• As far as you know, do cigarette packages in India have health warning on cigarette packages?– Yes: 326 (43%)– No: 340 (45%)– Don’t know: 94 (12%)