title: The ban on smokeless tobacco products is systematically violated in Chennai, India.
abstract: BACKGROUND
  India is the world's third largest consumer of tobacco. There are twice as many users of smokeless tobacco products (STPs) as cigarette smokers. The Government of Tamil Nadu has banned the sale of gutkha and pan masala in 2013. Our aim was to identify the varieties of illegal STP available in Chennai, India.
  
  
  METHODS
  In systematically chosen zones and regions of Chennai city, we randomly identified three kinds of kiosks (n = 18) and asked for "gutkha" and "pan masala," one of each product available. Details of each product were reviewed based on the information printed on the sachets.
  
  
  RESULTS
  Totally 65 STPs were collected; 26 distinct products and 23 brands. All products were claimed to be "tobacco" by the shop keepers. Sixty-five percent of the products informed to contain tobacco and 15.4% to contain pan masala. Five sachets did not inform about the content; 30.8% did not have a pictorial warning; a text warning was printed on 80.8%, but only two products had the messages in Tamil; 70% had promotional messages printed, and 57% had their registration numbers printed.
  
  
  CONCLUSIONS
  The ban on STP is being systematically violated in Chennai. STP are cheap and easily available and due to promotional laudatory messages and lacking information about the content and warning of health damage, the consumers are left with the perception that they buy more or less harmless product. The Indian Government must introduce policies to control production, import, and sale of illicit STP but we also call for a coordinated international solution.
authors.affiliation: Resource Center for Tobacco Control, Cancer Institute (W.I.A), Chennai, Tamil Nadu, India.
authors.forename: E
authors.initials: E
authors.lastname: Vidhubala
authors.affiliation: Research Center for Prevention and Health, Glostrup University Hospital and University of Copenhagen, Copenhagen, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Pisinger
authors.affiliation: Resource Center for Tobacco Control, Cancer Institute (W.I.A), Chennai, Tamil Nadu, India.
authors.forename: B
authors.initials: B
authors.lastname: Basumallik
authors.affiliation: Resource Center for Tobacco Control, Cancer Institute (W.I.A), Chennai, Tamil Nadu, India.
authors.forename: D S
authors.initials: DS
authors.lastname: Prabhakar
mesh_terms: D006801:Humans; D007194:India; D014030:Tobacco, Smokeless / Q000032:analysis / Q000331:legislation & jurisprudence*