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TobaccoFreeKids.org >
Katherine Shats
Legal Advisor, Campaign for Tobacco-Free Kids USA
Smokeless tobacco in Central Asia: working towards an
effective regulatory framework for nasvai in Tajikistan
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What is nasvai?
• a type of finely ground, moistened smokeless dipping tobacco product
• found in Tajikistan, Kazakhstan, Kyrgyzstan, Uzbekistan, Pakistan, Afghanistan, Iran and India
• prepared by mixing locally grown tobacco with slaked lime, alkaline tree ash and adding various flavors
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What is nasvai?
• high (and varying) levels of nicotine and tobacco specific nitrosamines, other toxic constituents and carcinogens
• most commonly sold as a bulk unlabeled product placed in container
• no standard contents or manufacturing process
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Nasvai in Tajikistan• High prevalence (up to 60%
of men aged 45-54) compared with low prevalence of smoking (9%)
• Widespread use – children, youth, adults, independent of socio-economic status
• Lack of knowledge of harms (or that it is a tobacco product)
• Roughly 1/3 of the price of cigarettes
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Potential policies for nasvai regulation
Education Educate consumers- Media campaigns- Warnings at points of saleEducate healthcare professionals
Regulation of the content - Ban on flavorings- Mandate contents disclosure
Regulation of the use - Ban the use in (specific) public places (e.g., health facilities, educational institutions, public offices, restaurants, etc.)
- Ban use by minors
Regulation of the market - Regulation of the saleo Ban sale outside of shopso Ban sale around schools and hospitals,o Ban sale and the purchase by minors
- Licensing system for sales
Advertising and promotion Comprehensive ban of all types of advertising and promotion, including point of sale display ban
Packaging and labeling - Standardized packaging: size, shape, material- Pictorial health warnings - Contents disclosure- Require name and contact of manufacturer
Tax; minimum price
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Challenges for regulation• Cottage industry, no formal market
• Lack of research – prevalence, health impacts, content, production, market etc
• Limited regulatory systems – capacity for enforcement, content analysis or standard development, licensing
• Poor or no understanding of health harms by population
• Little international experience, no ‘best practice’
• Ban or regulation Bans are difficult to enforce, have had limited success
Strict regulation could formalize the industry, attract more sophisticated players, or risk driving it further underground
Risk of users switching to combustible products
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First step: education campaign
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Conclusions
• Regulation of nasvai presents unique challenges
• Further research is needed on:• Prevalence and use• Content analysis• Health harms• Market dynamics• Population attitudes and beliefsto inform effective regulatory frameworks, educate target audiences (government, consumers, retailers, health professionals) and to develop cessation services
• Regional cooperation
• Global guidance and standard development
