Czaplicki Lauren, Zaman Raniyan, Balagere Sanjana, Rasheduzzaman A B M, Saraf Sejal, Islam M Shamimul, Cohen Joanna E
Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
BMJ Open. 2025 Apr 2;15(4):e094166. doi: 10.1136/bmjopen-2024-094166.
To qualitatively explore Bangladeshi adult males' perceptions of existing (tobacco-leaf cigarettes hand-rolled in tendu leaf) packs, which are currently sold in various shapes and sizes, often without the required graphic health warning label (HWL) covering 50% of the top of the pack, versus a proposed standard bidi pack, which was designed by advocates and is a cardboard, rectangular box shape with the required 50% HWL coverage.
Focus group study SETTING: Male participants were recruited from predetermined low-income urban and rural areas in three geographic divisions (Dhaka, Khulna, Sylhet) of Bangladesh.
98 males participated in 14 focus group discussions (FGDs). An equal number of groups were conducted with males who currently used bidis (n=7 groups) and males who never used tobacco (n=7 groups). Each group had 6-8 participants. For FGDs with males who used bidis, participants were eligible if they were at least 18 years old and reported smoking bidis on at least one of the past 30 days. For FGDs with males who never used tobacco, participants were eligible if they were between 18 and 35 years old to capture those at most risk of initiating tobacco and reported never using any tobacco.
Participants were shown four existing bidi packs sold in Bangladesh and one standard bidi pack. The groups were asked to first rank and discuss the existing bidi packs in terms of , and . Next, the groups discussed how the standard bidi pack compared with the existing bidi packs in terms of the same three outcomes.
All groups, regardless of bidi use status, discussed the limited noticeability of HWLs on existing bidi packs, which reduced perceived product harm. In contrast, most groups discussed how the standard pack HWL was clearly printed, easy to see and increased perceived harm. Overall, most groups across bidi use status found that the standard pack was as attractive or more attractive than the existing bidi packs, particularly noting that the standard pack shape, colour and cardboard material were attractive.
Standardising the size and shape of bidi packs has the potential to improve HWL compliance and increase harm perceptions. Complementing a standard bidi pack policy with a plain packaging policy (eg, packs only sold in a single drab olive colour), as well as efforts to enhance HWL compliance at the point of manufacturer, could further reduce product appeal and enhance harm perceptions.
定性探究孟加拉国成年男性对现有（用檀木叶手工卷制的烟草叶卷烟）包装的看法，这些包装目前有各种形状和尺寸，通常没有要求的图形健康警示标签（HWL）覆盖包装顶部的50%，而与之对比的是倡导者设计的标准比迪烟包装，它是一个硬纸板制成的矩形盒子形状，有要求的50% HWL覆盖。
焦点小组研究
男性参与者从孟加拉国三个地理区域（达卡、库尔纳、锡尔赫特）预先确定的低收入城乡地区招募。
98名男性参加了14次焦点小组讨论（FGD）。对目前使用比迪烟的男性（n = 7组）和从不使用烟草的男性（n = 7组）进行了数量相等的小组讨论。每个小组有6 - 8名参与者。对于与使用比迪烟的男性进行的FGD，参与者如果至少18岁且报告在过去30天中的至少一天吸食比迪烟，则符合条件。对于与从不使用烟草的男性进行的FGD，参与者如果年龄在18至35岁之间以涵盖最有可能开始使用烟草的人群且报告从未使用过任何烟草，则符合条件。
向参与者展示在孟加拉国销售的四种现有比迪烟包装和一种标准比迪烟包装。要求各小组首先根据[此处原文缺失具体评价维度内容]对现有比迪烟包装进行排名和讨论。接下来，各小组讨论标准比迪烟包装在相同的三个结果方面与现有比迪烟包装相比如何。
所有小组，无论比迪烟使用状况如何，都讨论了现有比迪烟包装上HWL的可注意性有限，这降低了对产品危害的认知。相比之下，大多数小组讨论了标准包装上的HWL印刷清晰、易于看到且增加了对危害的认知。总体而言，大多数不同比迪烟使用状况的小组发现标准包装与现有比迪烟包装一样有吸引力或更有吸引力，特别指出标准包装的形状、颜色和硬纸板材料很有吸引力。
对比迪烟包装的尺寸和形状进行标准化有可能提高HWL的合规性并增加对危害的认知。用素面包装政策（例如，包装仅以单一单调的橄榄色销售）补充标准比迪烟包装政策，以及在制造商层面加强HWL合规性的努力，可能会进一步降低产品吸引力并增强对危害的认知。
