Graphical health warning on bidi packets in Bangladesh: Current gaps and way forward

Introduction: Bidi (local handmade non-filtered cigarettes) is low-cost tobacco products in world and more than 150 stick bidis (6 packs, one pack = 25 sticks) for only US$1 (85 BDT). Poor, ultra poor and illiterate people smoke bidis. 5.3 million Or 5% Adults (15+ years) smoked bidis and, on an average of 13.7 bidis smoked per day (GATS Bangladesh 2017). Objectives: Graphical Health Warnings (GHW) on both side of all tobacco products including covering 50% or more surface area and “approved for selling only in Bangladesh” were imposed from 19th March 2016 as per amendment of the Smoking and Tobacco Products Uses. Methods: Samples of bidi packets were collected from 160 wholesale shops situated in the 270 bazars (market area) in the 64 district towns during October 2017 to September 2019. Total 139 samples of different packets were collected owned by 39 brands of 30 companies. Results: Among all tobacco products available in Bangladesh, GHWs enforcement on the bidi packs are worst. 1. Only 18% packets contains both side of GHWs: - 82% bidi packets has no GHWs in both side which is a clear violation of law. - GHWs in 91% packs are covered by band-roll (tax-stamp). 2. 94% bidi packets doesn’t write the sentence “approved for selling only in Bangladesh” that is a legal obligation of tobacco packets. 3. None of bidi packets were found that fully compliance the tobacco control law. Conclusion(s): Standard and unique packaging of bidi packets can ensure full compliance of TC law. TCRC initiated sensitizing concerned government agencies with these findings to make standard packaging for tobacco products.