Sankaran Sujatha, Hiilamo Heikki, Glantz Stanton A
Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA.
Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
Tob Control. 2015 Nov;24(6):547-55. doi: 10.1136/tobaccocontrol-2013-051536. Epub 2014 Jun 20.
To understand the competition between and among tobacco companies and health groups that led to graphical health warning labels (GHWL) on all tobacco products in India.
Analysis of internal tobacco industry documents in the Legacy Tobacco Document Library, documents obtained through India's Right to Information Act, and news reports.
Implementation of GHWLs in India reflects a complex interplay between the government and the cigarette and bidi industries, who have shared as well as conflicting interests. Joint lobbying by national-level tobacco companies (that are foreign subsidiaries of multinationals) and local producers of other forms of tobacco blocked GHWLs for decades and delayed the implementation of effective GHWLs after they were mandated in 2007. Tobacco control activists used public interest lawsuits and the Right to Information Act to win government implementation of GHWLs on cigarette, bidi and smokeless tobacco packs in May 2009 and rotating GHWLs in December 2011.
GHWLs in India illustrate how the presence of bidis and cigarettes in the same market creates a complex regulatory environment. The government imposing tobacco control on multinational cigarette companies led to the enforcement of regulation on local forms of tobacco. As other developing countries with high rates of alternate forms of tobacco use establish and enforce GHWL laws, the tobacco control advocacy community can use pressure on the multinational cigarette industry as an indirect tool to force implementation of regulations on other forms of tobacco.
了解烟草公司与健康组织之间的竞争情况，正是这种竞争促使印度对所有烟草产品实施图形健康警示标签（GHWL）。
分析遗产烟草文档库中的烟草行业内部文件、通过印度《信息权法》获取的文件以及新闻报道。
印度实施图形健康警示标签反映了政府与卷烟及比迪烟行业之间复杂的相互作用，它们既有共同利益，也有冲突利益。国家级烟草公司（跨国公司的外国子公司）和其他形式烟草的本地生产商联合游说，数十年来阻碍了图形健康警示标签的实施，并在2007年强制要求实施有效图形健康警示标签后拖延了其实施进程。控烟活动人士利用公益诉讼和《信息权法》，促使政府于2009年5月在卷烟、比迪烟和无烟烟草包装上实施图形健康警示标签，并于2011年12月实施轮换图形健康警示标签。
印度的图形健康警示标签说明了同一市场中比迪烟和卷烟的存在如何营造出一个复杂的监管环境。政府对跨国卷烟公司实施烟草控制导致了对本地烟草形式的监管执行。随着其他使用替代烟草形式比例较高的发展中国家制定并执行图形健康警示标签法律，控烟倡导团体可以将对跨国卷烟行业施加压力作为一种间接手段，迫使对其他烟草形式实施监管。
