Availability, accessibility and promotion of smokeless tobacco in a low-income area of Mumbai.
Availability, accessibility and promotion of smokeless tobacco in a low-income area of Mumbai.
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DOI：
10.1136/tobaccocontrol-2011-050148
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发表时间：
2013-09
期刊：
影响因子：
5.2
通讯作者：
Donta B
中科院分区：
文献类型：
--
作者：
Schensul JJ;Nair S;Bilgi S;Cromley E;Kadam V;Mello SD;Donta B
使用地理信息系统（GIS）、观察和访谈方法，在孟买一个典型的低收入社区中，研究可及性、产品可用性、促销和社会规范推广的作用，以及促使无烟烟草（ST）产品使用的因素，并评估《卷烟和其他烟草产品法》（COTPA）立法的实施情况。印度是世界第三大烟草生产国，男女老少都使用无烟烟草产品。新形式的高成瘾性包装无烟烟草产品，如gutkha，价格低廉，在低收入城市社区的使用率较高。众所周知，这些产品会增加口腔癌的发病率，并影响生殖健康和胎儿发育。这项研究采用了一种混合方法，将人种学和地理信息系统制图、观察和关键线人访谈结合起来。可及性被定义为居民和学校到烟草销售点的密度、聚集程度和距离。观察和采访数据与店主和社区居民产生的产品档案，信息商店的历史和收入和规范的声明。空间分析表明，高密度的出口与各亚社区的变化。所有居民都可以在离家30 - 100英尺的范围内找到烟草店。55个答复者的规范性陈述表明，接受男子、妇女和儿童吸烟，据报告，销售无烟烟草是一些家庭的一种重要创收形式。需要多层次的烟草控制和预防战略，包括烟草教育、社区规范改变、许可证发放和监督以及替代性创收战略，以减少无烟烟草使用的可及性和可获得性。
To examine the role of accessibility, product availability, promotions and social norms promotion, factors contributing to the use of smokeless tobacco (ST) products in a typical low-income community of Mumbai community using Geographic Information System (GIS), observational and interview methodologies and to assess implementation of Cigarettes and other Tobacco Products Act (COTPA) legislation. In India, the third largest producer of tobacco in the world, smokeless tobacco products are used by men, women and children. New forms of highly addictive packaged smokeless tobacco products such as gutkha are inexpensive and rates of use are higher in low-income urban communities. These products are known to increase rates of oral cancer and to affect reproductive health and fetal development. The study used a mixed methods approach combining ethnographic and GIS mapping, observation and key informant interviews. Accessibility was defined as density, clustering and distance of residents and schools to tobacco outlets. Observation and interview data with shop owners and community residents produced an archive of products, information on shop histories and income and normative statements. Spatial analysis showed high density of outlets with variations across subcommunities. All residents can reach tobacco outlets within 30–100 feet of their homes. Normative statements from 55 respondents indicate acceptance of men’s, women’s and children’s use, and selling smokeless tobacco is reported to be an important form of income generation for some households. Multilevel tobacco control and prevention strategies including tobacco education, community norms change, licensing and surveillance and alternative income generation strategies are needed to reduce accessibility and availability of smokeless tobacco use.