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Since economic liberalization in 1991, India has been experiencing rapid economic growth and a shift to consumer culture, making it fertile ground for marketers of consumer goods. Historically, sales of beauty products in India had been limited by high taxation, restricted consumer choice, and high levels of poverty; post-liberalization, the country was therefore seen as a market with immense, albeit untapped, potential. However, even as beauty industry reports tout the potential for growth, nearly three decades after liberalization, per capita sales of beauty products continue to be some of the lowest in the world. Little is known about why beauty products remain stubbornly resistant to aspirational marketing efforts. Meanwhile, scant social scientific attention has been paid to the creation and marketing of tastes and desires by the beauty industry in India and women's engagement with those desires. In this article, we present ethnographic depth on how local beauty cultures affect understandings of bodily aesthetics to create hybrid beauty practices and on how marketing efforts seek to channel these practices into consumer behavior. We examine some of the major points of contingent difference linked to low volumes of cosmetics sales in India and explore the approaches adopted by advertisers and marketers of beauty products to convert such difference into new imaginaries that foster mass consumption. [ABSTRACT FROM AUTHOR]

Background: This paper describes a pioneering effort to introduce tobacco cessation into India's undergraduate medical college curriculum. This is the first ever attempt to fully integrate tobacco control across all years of medical college in any low and middle income country. The development, pretesting, and piloting of an innovative modular tobacco curriculum are discussed as well as challenges that face implementation and steps taken to address them and to advocate for adoption by the Medical Council of India. Methods: In-depth interviews were conducted with administrators and faculty in five medical colleges to determine interest in and willingness to fully integrate smoking cessation into the college curriculum. Current curriculum was reviewed for present exposure to information about tobacco and cessation skill training. A modular tobacco curriculum was developed, pretested, modified, piloted, and evaluated by faculty and students. Qualitative research was conducted to identify challenges to future curriculum implementation. Results: Fifteen modules were successfully developed focusing on the public health importance of tobacco control, the relationship between tobacco and specific organ systems, diseases related to smoking and chewing tobacco, and the impact of tobacco on medication effectiveness. Culturally sensitive illness specific cessation training videos were developed. Faculty and students positively evaluated the curriculum as increasing their competency to support cessation during illness as a teachable moment. Students conducted illness centered cessation interviews with patients as a mandated part of their coursework. Systemic challenges to implementing the curriculum were identified and addressed. Conclusions: A fully integrated tobacco curriculum for medical colleges was piloted in 5 colleges and is now freely available online. The curriculum has been adopted by the state of Kerala as a first step to gaining Medical Council of India review and possible recognition. [ABSTRACT FROM AUTHOR]

Background: Results of the Global Adult Tobacco Survey in Kerala, India found that 42 % of adults were exposed to second hand smoke (SHS) inside the home. Formative research carried out in rural Kerala suggests that exposure may be much higher. Numerous studies have called for research and intervention on SHS exposure among women and children as an important component of maternal and child health activities. Methods: Community-based participatory research was carried out in Kerala. First, a survey was conducted to assess prevalence of SHS exposure in households. Next, a proof of concept study was conducted to develop and test the feasibility of a community-wide smoke free homes initiative. Educational materials were developed and pretested in focus groups. After feasibility was established, pilot studies were implemented in two other communities. Post intervention, surveys were conducted as a means of assessing changes in community support. Results: At baseline, between 70 and 80 % of male smokers regularly smoked inside the home. Over 80 % of women had asked their husband not to do so. Most women felt powerless to change their husband's behavior. When women were asked about supporting a smoke free homes intervention, 88 % expressed support for the idea, but many expressed doubt that their husbands would comply. Educational meetings were held to discuss the harms of second hand smoke. Community leaders signed a declaration that their community was part of the smoke free homes initiative. Six months post intervention a survey was conducted in these communities; between 34 and 59 % of men who smoked no longer smoked in their home. Conclusions: The smoke free homes initiative is based on the principle of collective efficacy. Recognizing the difficulty for individual women to effect change in their household, the movement establishes a smoke free community mandate. Based on evaluation data from two pilot studies, we can project that between a 30 and 60 % reduction of smoking in the home may be achieved, the effect size determined by how well the smoke free home steps are implemented, the characteristics of the community, and the motivation of community level facilitators. [ABSTRACT FROM AUTHOR]

Aims Previously reported research suggests a dependence syndrome for areca nut use, though well-designed studies are virtually non-existent. The goal of this study was to examine evidence of areca dependence in a sample of areca-only (i.e. no tobacco) chewers using modified measurement scales. Design A purposive sample of chewers, identified via local informants and advertisements, was surveyed from January to March of 2005. Setting Six villages in Dakshina Kannada District, Karnataka State, India. Participants Fifty-nine daily areca chewers who do not also currently use any form of tobacco. Measurements Questionnaires included modified versions of the Fagerström Tolerance Questionnaire, Cigarette Dependence Scale (CDS-5) and the Smokeless Tobacco Dependence Scale (STDS). Additional questions assessed demographic characteristics and patterns of use. Findings Approximately half of respondents reported 1–3 chews/day (mean = 1.9; SD = 0.98). The average number of chewing episodes/day was 4.4 (SD = 3.4) and the average number of nuts/day was 1.2 (SD = 1.1). Users’ typical chew lasts up to 20 minutes and includes spitting out the juices and rinsing the mouth with water. Overall, the levels of reported dependence symptoms were quite low, but approximately 44% of chewers endorsed at least one of the following items: continued use despite illness or mouth wounds, difficulty refraining from chewing in forbidden places, or craving during periods of abstinence. Approximately 15.4% of chewers reported at least one intentional quit attempt and a subset had summary scores indicative of dependence (13.6% had scores >16 on the CDS-5 and 5.3% had scores >11 on the STDS). Dependence scores were positively correlated with frequency of chews/day. Conclusions The symptoms of dependence observed in a subset of areca-only chewers warrant further investigation. Next steps should include well-controlled laboratory evaluation of dependence features. [ABSTRACT FROM AUTHOR]

This paper examines popular perceptions of tobacco products and describes patterns of use among college youth in Karnataka, India. Data are drawn from 25 key informant interviews and six focus groups with male and female college students, interviews with shopkeepers, observational data on youth tobacco consumption, and a college-based survey. The survey was administered to 1587 males attending eleven colleges.Forty-five percent (n=716) of college students surveyed had used tobacco products. Thirty-six percent (n=573) had tried cigarettes, 10% (n=157) had tried bidis, and 18% (n=290) had tried gutkha. Tobacco consumption among smokers was low; for daily smokers, the mean number of cigarettes smoked was 6 per day. Students attending professional colleges, including engineering, medicine, and law were significantly more likely to have ever smoked and to be daily smokers when compared to students enrolled in other courses of study.In interviews, male students noted that smoking a cigarette enhanced one''s manliness, relieved boredom, and eased tension. Although female students interviewed were non-smokers, several suggested that in the future, smoking might be an acceptable behavior among college-going females. When asked about their perceptions of smoking among youth in Western countries, the majority of students believed that three-quarters of male and female youth in the West smoked. This perception has been largely formed through media images, including satellite television and films.With regard to addiction, it was widely believed that filter-tipped cigarettes were one of the most addictive products because they are made of better quality tobacco, and are milder and smoother to smoke. Therefore, a person could easily smoke more of them, which would lead to addiction. Another widely held belief was that the more expensive the cigarette, the less harmful it was for one''s health. [Copyright &y& Elsevier]

Abstract: In developing nations where reductions in tobacco use have not been realized, it is critical that health professionals be encouraged to abstain from tobacco use. Data on tobacco use among health professionals in India are limited. We conducted cross-sectional surveys among 110 male medical school faculty (MSF), 229 physicians (67% male), 1130 medical students (46% male), and 73 female nursing students. Information on tobacco use and quit attempts was collected using structured questionnaires. Among the male respondents, current smokers were 15.1% of MSF, 13.1% of physicians, and 14.1% of medical students. Among current smokers, 42% of MSF and physicians and 51% of medical students had not attempted quitting in the last year. However, one third of MSF and physicians and 16% of medical students had attempted to quit at least 4 times. This is one of the first studies among health care professionals in India. Our findings show that a substantial proportion of physicians and medical students in Kerala continue to smoke. Smoking cessation programs are warranted in medical schools in Kerala. An initiative is presently underway by the authors to incorporate tobacco education into the medical school curriculum. [Copyright &y& Elsevier]