title: Insights into pictorial health warnings on tobacco product packages marketed in Uttar Pradesh, India.
abstract: BACKGROUND
  The Government of India issued an undertaking in the Supreme Court mandating pictorial health warnings (PHWs) on packages of tobacco products from 31st May, 2009 under " Cigarettes and Other Tobacco Products Act " (COTPA) guidelines. This constitutes a key economic channel for educating people on devastating health impacts of deadly products within in a vivid and memorable way. Few studies have investigated PHWs on tobacco products marketed in India.
  
  
  OBJECTIVE
  To assess met guidelines for pictorial health warnings under packaging and labeling rules on packages of collected tobacco products specified by COTPA.
  
  
  METHODS
  Snowball/network sampling design was followed to obtain samples of 37 different tobacco brands, 18 in smoking form (12 cigarette, 6 bidi brands) and 19 in smokeless form (4 chewing tobacco, 11 Gutkha and 4 Khaini brands) marketed at retail outlets at Muradnagar. They were analyzed for their compliance with guidelines through checklist by one calibrated examiner.
  
  
  RESULTS
  PHWs were absent on packages of 5 tobacco brands. Fifteen tobacco brands had PHWs smaller than stipulated 40% of principal display area; 6 brands of bidis had PHWs on deceptive backgrounds, 3 of which were placed on a curved axis. Misleading descriptors and promotional messages were also present.
  
  
  CONCLUSIONS
  Locally marketed tobacco products were not compliant with packaging and labeling rules specified by COTPA. This highlights the need for more stringent implementation of COTPA guidelines to combat the ever-growing tobacco menace.
authors.affiliation: Department of Public Health Dentistry, I.T.S Center for Dental Studies and Research, Muradnagar, District, India. arunads_samay@yahoo.com
authors.forename: Aruna
authors.initials: A
authors.lastname: D S
authors.forename: G
authors.initials: G
authors.lastname: Rajesh
authors.forename: Vikrant Ranjan
authors.initials: VR
authors.lastname: Mohanty
mesh_terms: D000329:Advertising; D006293:Health Promotion; D006801:Humans; D007194:India; D019064:Product Packaging; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention