Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.3
,
No
.4
, Dece
m
b
er
2
014
,
p
p
.
2
5
9
~
266
I
S
SN
: 225
2-8
8
0
6
2
59
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Effect of
Indirect
Tob
a
cco Ad
vert
isement
and Promotion
Activities in Ban
g
lad
e
sh
Q
a
zi A
z
a
d
-u
z-
za
m
a
n
,
Q
u
a
z
i Za
h
a
n
g
ir Ho
ss
a
i
n
Department o
f
P
ublic Health, Northe
rn Univ
ers
i
t
y
B
a
ngl
ades
h,
B
a
nglad
es
h
Article Info
A
B
STRAC
T
Article histo
r
y:
Received
Oct 26, 2014
Rev
i
sed
Nov
1
7
, 2
014
Accepted Nov 27, 2014
Different forms of indirect tobacco ad
v
e
rtisemen
t and promotion
a
l activities
are th
e burden
of tobacco ep
id
emic in Bang
ladesh. A descrip
tive
ty
pe o
f
cross-sectional stud
y
w
a
s carr
i
ed out on a
total of 404 adults, random
ly
selected from
urban (206)
an
d rural
(198)
areas. Data were co
llected
implementing b
o
th qualitative and qua
ntitative methods from July
to
September 2013 and found 52% of the
respondents were smoking cigar
e
tte
or bidi, within
t
h
em
onl
y
30% o
f
the m
a
le adul
ts
were never us
er
of tobacco
of an
y
kind
. The respondents mainly
noticed packet wall (52
%), posters
(65%), and
big
s
i
ze p
acke
t
s
(38
%) as
ind
i
re
ct
a
dvertis
em
ent
as
well
as
fre
e
sample (51%) and free gifts (43%) as
promoti
onal activities.
A significan
t
effec
t
was iden
tified of
the
ac
tivit
ies on incr
easing consum
ption whic
h
tobacco con
t
rol
advocates and p
r
act
ition
e
rs alway
s
argu
e.
Existi
ng laws d
o
not allow giv
i
ng
free samples an
d free gi
ft to
per
s
ons, it should
b
e
enfor
ced
adequately
as well
as all tobacco
con
t
rol
activists should be vigilant on
unlawful
act
ivit
i
e
s of tob
a
c
c
o
tra
d
ers.
Keyword:
Indirect a
d
vertisem
ent
Pro
m
o
tio
n activ
ities
Sm
oki
ng t
obac
c
o
Teena
g
ers
Tobacco control
Copyright ©
201
4 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
Qazi Aza
d
-uz
-
za
m
a
n,
Depa
rt
m
e
nt
of
Pu
bl
i
c
Heal
t
h
,
No
rt
he
rn
U
n
i
v
ersi
t
y
B
a
ngl
a
d
esh,
41/
42
M
azi
d
S
a
rani
,
S
h
i
b
bari
C
i
rcl
e
, K
hul
na,
B
a
n
g
l
a
des
h
.
Em
ail: aazad013@yahoo.c
om
1.
INTRODUCTION
According to Section 2(
b) “
T
obacco” m
e
a
n
s any
N
i
cot
i
m
a T
o
bac
u
m
or
Nico
tima
Bu
stica
pl
a
n
t
o
r
any ot
her
related
plant
or its
leaf or c
r
op
[1]; an
d of
Art
i
cle 1(c) “T
obacco
Adve
rtising and
Prom
otion”
means any
form
of comm
er
ci
al
com
m
uni
cat
i
on,
rec
o
m
m
endat
i
o
n
o
r
ac
tion with
t
h
e aim
,
effect or likely
effect of promoting a t
obacc
o product
or tobacco
use either directly or i
ndi
rectly [2]. Article 1(f) “
T
obac
c
o
Pro
d
u
ct
s” m
eans
pr
o
duct
s
ent
i
rel
y
or
pa
rt
l
y
m
a
de o
f
t
h
e le
af tobacc
o as
raw m
a
terial which are
m
a
nufacture
d
to be
used
for sm
oking, sucking,
c
h
ewi
n
g or s
n
uffi
ng
[2]; and also
Section
2(c
)
s
t
ated that “Tobacco
Products” m
e
a
n
s any product
m
a
de from
tobacco
whic
h can be inhale
d through sm
oking a
nd s
h
all include
bi
di
, ci
garet
t
e
,
cher
o
o
t
,
ci
ga
r
an
d m
i
xt
ures
use
d
i
n
pi
pe
[
1
]
.
B
u
t
t
o
bacc
o
pr
od
uct
s
, e
s
peci
al
l
y
ci
gare
t
t
e
s are
am
ong t
h
e m
o
st
m
a
rketed products in
the
world [2]. In
Article 1(e
)
“
T
obacco
Indus
t
ry”
m
eans tobacco
manufact
ure
r
s, wholesale di
s
t
ribut
ors a
n
d im
porters of tobacco products [2].
The t
o
bacco industry
spe
nds
billions
of
dollar each yea
r
to
m
a
rket its products. In
places where a
d
vert
ising is
perm
itt
ed, the largest single
expe
n
d
i
t
u
re
by
t
obacc
o c
o
m
p
ani
e
s i
s
de
v
o
t
e
d t
o
a
d
vert
i
s
i
n
g an
d
pr
om
ot
i
on
[
2
]
.
The
i
n
dust
r
y
uses
a
m
i
x of
to
b
acco
adv
e
rtisin
g
,
p
r
o
m
o
t
i
o
n, and
sp
on
sor tactics to
d
i
rectly in
flu
e
n
ce t
o
b
acco
u
s
e and
attitu
d
e
s related
to
to
b
acco
[3
]. Th
e tob
acco
indu
stry m
a
in
tain
s th
at th
e ro
le o
f
adv
e
rtising
is
to
en
co
urage sm
o
k
e
rs to
switch
b
r
and
s
. Brand
i
n
g
is
u
s
ed
t
o
disco
u
rag
e
sm
o
k
e
rs
fro
m
q
u
ittin
g
,
t
o
en
cou
r
ag
e n
e
w sm
o
k
e
rs, an
d
to
un
d
e
rm
in
e
rest
ri
ct
i
ons
o
n
t
obacc
o m
a
rket
i
ng [
4
]
.
H
o
weve
r, i
n
d
u
st
r
y
doc
um
ent
s
have s
h
ow
n t
h
at
ad
vert
i
s
i
n
g
causes
characte
r
istics suc
h
as i
nde
pe
nde
n
ce, glam
our and m
achism
o
to be
ass
o
c
i
ated
with sm
oking [5].
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJPHS
Vol. 3, No. 4,
Decem
ber 2014
: 259 –
266
26
0
Ad
ve
rt
i
s
i
ng i
n
creases t
o
bacc
o co
ns
um
pt
i
on [6]
,
y
o
u
n
g
pe
opl
e are
part
i
c
ul
arl
y
vul
nera
bl
e t
o
i
t
and
are th
e m
a
in
targ
et
of
b
r
an
d stretch
i
ng
[7
]-[11
].
To
ba
cco a
d
vert
i
s
i
n
g i
s
al
s
o
use
d
t
o
t
a
r
g
et
w
o
m
e
n.
Adve
rtising
gl
a
m
orizes tobac
c
o
use a
n
d m
a
kes it s
o
cia
lly acceptable
[4]. About
half
of the
world’s
c
h
ildre
n
l
i
v
e i
n
c
o
unt
ri
es t
h
at
al
l
o
w t
h
e
free
di
st
ri
b
u
t
i
o
n
of t
o
bacc
o
pr
o
duct
s
[
1
2
]
. To
bacc
o
use
i
s
am
ong
t
h
e l
eadi
n
g
pre
v
e
n
t
a
bl
e causes o
f
deat
h.
Each y
ear, t
h
e
gl
obal
t
o
bacc
o epi
d
em
i
c
ki
ll
s nearl
y
m
i
ll
ion
peo
p
l
e
, i
n
c
l
udi
n
g
m
o
re th
an
60
0,0
0
0
wh
o d
i
e
fro
m
ex
p
o
sure t
o
secon
d
-h
and
sm
o
k
e
[6
].
It is on
track
t
o
k
ill
m
o
re th
an 8
m
illio
n
by
2
0
3
0
,
by
w
h
i
c
h t
i
m
e appr
oxi
m
a
t
e
l
y
80% of t
h
e deat
h
s
wo
ul
d
occ
u
r
i
n
l
o
w a
n
d m
i
ddl
e
-
i
n
c
o
m
e
cou
n
t
r
i
e
s
[13
]
. On
e of the
m
a
in
b
e
h
a
v
i
o
u
ral h
ealth
risk
s fo
r a
h
o
st of chron
i
c illn
ess is th
e u
s
e of
to
b
acco
and
related
products.
Accordi
ng to the
Worl
d H
ealth Organization re
port on the Gl
obal Tobacco E
p
idem
ic 2008, nearly
two-th
ird
s
o
f
th
e
world’s sm
o
k
e
rs liv
e in
10
co
un
trie
s i
n
c
l
udi
n
g
B
a
n
g
l
a
des
h
. S
o
m
e
35
% o
f
m
e
n i
n
d
e
vel
o
ped
countries a
n
d 50% of m
e
n in de
ve
loping countries are daily s
m
oker
s. T
o
bacco-use is a wi
de
sprea
d
phe
n
o
m
e
non i
n
B
a
ngl
a
d
es
h.
The G
ove
r
n
m
e
nt
has t
a
ken st
eps t
o
wa
r
d
s di
sco
u
ra
gi
n
g
sm
oki
ng t
h
r
o
u
g
h
si
gni
ng
the Fram
ework Conve
ntion
on T
o
bacco C
ont
rol, thus
, re
stricting adve
rtising and
sm
oking in public places
[14]. In Dece
m
b
er 1998,
Tobacco
Fr
ee
Ini
tiative (TFI) c
o
nve
n
ed a m
eeti
ng in
Gene
va with the Centers for
Di
sease C
ont
r
o
l
an
d
Pre
v
e
n
t
i
on
(C
DC
), t
h
e U
n
i
t
e
d
Nat
i
ons
C
h
i
l
d
re
n’s
Fu
n
d
(
U
NIC
E
F),
t
h
e
Wo
rl
d B
a
n
k
(W
B
)
a
n
d re
presentatives
from
countries i
n
each
of the
si
x WHO re
gions
t
o
discuss
the
need
for sta
nda
rdized
m
echani
s
m
s
t
o
col
l
ect
y
out
h t
obacc
o
use i
n
f
o
rm
at
i
on o
n
a
gl
o
b
al
basi
s
[1
5]
. Am
ong
ot
h
e
r m
easures t
o
red
u
ce
t
h
e b
u
r
d
e
n
o
f
t
h
e t
o
bacc
o epi
d
em
i
c
, t
h
e con
v
ent
i
o
n
req
u
i
r
e
s
co
unt
ri
es t
o
pr
ot
ect
t
h
ei
r ci
t
i
zens fr
om
expos
u
r
e
t
o
t
o
bacc
o sm
oke
. B
a
ngl
a
d
e
s
h
was a
n
earl
y
si
gnat
o
ry
t
o
t
h
e C
o
n
v
ent
i
o
n i
n
20
0
4
. T
h
e
U
n
i
t
e
d
St
at
es
si
gne
d
t
h
e ag
reem
ent
i
n
2
0
0
4
,
but
t
h
e act
i
o
n
has
not
y
e
t
bee
n
r
a
t
i
f
i
e
d. M
a
ny
cou
n
t
r
i
e
s
ha
ve
ad
opt
e
d
part
i
a
l
ban
s
co
v
e
ring
d
i
rect ad
v
e
rtisin
g in
trad
itio
nal
m
e
d
i
a
ch
an
n
e
ls;
h
o
wever, few cou
n
tries h
a
v
e
ado
p
t
ed
com
p
rehe
nsi
v
e
bans
o
n
al
l
t
y
pes of
di
rect
a
n
d i
n
di
rect
m
a
rket
i
ng [
1
6]
. The
m
i
ssi
on of t
h
e
Int
e
r
n
at
i
o
nal
Uni
o
n
agai
nst
T
ube
rc
ul
osi
s
a
nd
Lu
n
g
Di
sease
(T
he
Uni
o
n
)
i
s
t
o
br
i
ng i
n
n
ovat
i
o
n
,
expe
rt
i
s
e, s
o
l
u
t
i
ons a
nd s
u
pp
ort
t
o
add
r
ess
heal
t
h
chal
l
e
ng
es i
n
l
o
w
-
a
n
d m
i
ddl
e-i
n
c
o
m
e
pop
u
l
at
i
ons [
1
8]
.
The
Uni
on
ha
s bee
n
w
o
r
k
i
n
g o
n
t
o
bacc
o
cont
rol
i
n
B
a
n
g
l
a
des
h
si
nce
20
0
7
u
n
d
er t
h
e B
l
oom
berg
In
itiativ
e to
R
e
d
u
c
e To
b
acco Use. Gl
ob
ally, th
e
Dep
a
rtm
e
n
t
of Tob
acco
Co
n
t
ro
l,
b
e
en
work
i
n
g
to adv
a
n
ce
to
b
acco
con
t
rol in
lo
w- an
d
mid
d
l
e-in
co
m
e
co
un
tries fo
r
m
o
r
e
th
an
25
year
s, w
ith
a fo
cus on
supp
or
ti
ng
effective t
o
ba
cco c
ont
rol
programm
ers though
gra
n
ts a
n
d prom
oting
effective
tobacco c
ont
rol t
h
rough
t
r
ai
ni
n
g
, re
so
ur
ces and
resea
r
c
h
[
18]
. T
h
e
use
of
di
rect
t
o
bac
c
o ad
vert
i
s
i
n
g
i
s
bei
ng
rest
ri
c
t
ed or
p
r
o
h
i
b
i
t
ed i
n
a gr
o
w
i
n
g
num
ber
o
f
c
o
u
n
t
r
i
e
s [
19]
.
Thi
s
ha
s l
e
d t
o
an
i
n
c
r
ease i
n
t
h
e
use
of i
ndi
rect
ad
v
e
rt
i
s
i
ng t
h
at
i
n
cl
udes
spo
n
s
o
r
s
hi
p [
A
rt
i
c
l
e
1(
g) “t
obacc
o s
p
o
n
s
o
rshi
p” m
eans any
fo
rm
of cont
ri
b
u
t
i
on t
o
any
eve
n
t
,
act
i
v
i
t
y
or
i
ndi
vi
dual
wi
t
h
t
h
e
ai
m
,
effe
ct
or
l
i
k
el
y
ef
f
ect
of
p
r
om
o
t
i
n
g a t
o
b
acco
pr
odu
ct or
t
oba
cco use
eit
h
er directly
or i
n
di
rect
l
y
[2]
o
f
sp
ort
s
,
cul
t
u
ral
an
d
m
u
si
c event
s
, im
age and
l
ogo a
dve
rt
i
s
i
n
g
,
m
e
rchandi
si
n
g
,
m
a
ni
pul
at
i
n
g pack
desi
g
n
s
,
and
pr
o
duct
p
l
acem
e
nt
i
n
t
e
l
e
vi
si
on s
h
ows
and
fi
lm
s [1
9]
.
WHO
decl
ares a
com
p
rehe
nsi
v
e
ba
n
on
al
l
ad
vert
i
s
i
n
g,
p
r
o
m
oti
on,
an
d s
p
ons
o
r
shi
p
pr
ot
ect
s pe
opl
e
fr
o
m
i
ndu
st
ry
m
a
rket
i
n
g
tactics and could dec
r
ease tobacco cons
um
ption by
about 7%
and pa
rtial
bans
ha
ve little or
no e
ffect
[20]. On
t
h
e face
of
di
ffe
rent
rest
ri
ct
i
ons
, t
h
e
t
o
ba
cco i
n
d
u
st
ry
f
r
eq
ue
nt
l
y
cha
n
ges a
n
d a
d
opt
s ne
w
ap
pr
oa
ch
fo
r
pr
om
ot
i
on of
t
h
ei
r
t
obacc
o p
r
od
uct
s
.
In t
h
e
s
e re
gar
d
t
h
ere i
s
n
o
o
r
scant
y
st
udy
h
a
s been
fo
u
nd
on t
h
e t
obac
c
o
cont
r
o
l
i
ssues
i
n
Kh
ul
n
a
areas. T
h
e study ha
d bee
n
c
a
rried
out
to know the e
ffect
of indirect t
obacco adve
rtisement and
prom
otional
activ
ities as well as to
k
n
o
w th
e fo
rm
o
f
th
ose activ
ities b
y
th
e co
m
p
an
ies in
d
i
fferen
t
rural an
d
u
r
b
a
n
areas i
n
Kh
ul
na
o
f
B
a
n
g
l
a
des
h
.
2.
R
E
SEARC
H M
ETHOD
M
i
xed m
e
t
hod
was appl
i
e
d fo
r dat
a
col
l
e
c
t
i
on. A
descri
pt
i
v
e t
y
pe of
cross
-
sect
i
o
nal
st
udy
was
carri
ed
o
u
t
i
n
bot
h
ur
ba
n an
d
ru
ral
are
a
s
of
Kh
ul
na
di
st
ri
ct
of
B
a
n
g
l
a
des
h
as t
h
e a
r
ea c
o
nsi
s
t
s
o
f
9
Up
azi
l
a
s
(B
at
i
a
ghat
a
,
D
acope
, D
u
m
u
ri
a, Di
g
h
al
i
a
, K
o
y
r
a, Pai
kgac
h
ha, P
hul
t
a
l
a
, R
ups
ha
, an
d Ter
o
k
h
a
d
a) a
nd
5
Tha
n
a
(Kh
a
lishp
ur, Kh
an
Jah
a
n
Ali, Ko
twali, Dau
l
atp
u
r a
nd S
o
n
a
dan
g
a
)
. B
a
t
i
a
ghat
a
U
p
azi
l
a
and
Kot
w
al
i
(Sada
r
)
Tha
n
a we
re se
lected random
l
y from
K
hul
na
di
st
ri
ct
fo
r t
h
e st
udy
. M
a
r
k
e
t
s were l
i
s
t
e
d
up t
o
m
a
ke a fram
e
.
Prob
ab
ility Pro
portio
n
a
l t
o
Size (PPS) samp
lin
g techn
i
que
was adop
ted fo
r t
h
e selecti
o
n of
3
m
a
rk
et
s fro
m
each a
r
ea. Adult
m
a
le
m
e
m
b
e
r
of the
hous
e
hol
d
of s
u
rr
oundi
ng area
to the m
a
rket
re
sponde
d
for t
h
e
survey
i
rres
p
ect
i
v
e o
f
sm
oki
n
g
. O
f
40
4
h
o
u
se
h
o
l
d
s
,
20
6 a
nd
19
8
ho
use
hol
ds w
e
re su
rvey
e
d
f
r
om
urba
n an
d
rural
areas
respecti
v
ely following s
y
ste
m
atic sa
mp
lin
g pro
cedu
r
e with
ran
d
o
m
start.
Qu
alitativ
e m
e
th
od
in
cl
u
d
e
s
Fo
cu
s
Gro
u
p
Discu
ssi
on
(nu
m
b
e
r o
f
fo
cus g
r
ou
p
was
10
in
cl
u
d
i
ng
t
obacc
o p
r
om
ot
i
onal
wo
rke
r
s, p
o
i
n
t
o
f
sal
e
ow
ner
,
u
n
i
v
ersi
t
y
st
udent
s
,
farm
ers, et
c)
. The resea
r
c
h
was
main
ly b
a
sed
o
n
th
e resu
lts
o
f
qu
estionn
aire surv
ey
wh
ereas resu
lts from
FGD were
u
s
ed
to su
pp
lemen
t
th
e
survey results.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Effect o
f
In
d
i
rect Tob
a
c
co
Advertisemen
t
a
n
d
Promo
tion
Activities in
Ba
ng
lad
e
sh
(Qa
z
i
Azad
-u
z-zaman
)
26
1
3.
R
E
SU
LTS AN
D ANA
LY
SIS
Resu
lts ob
tained
fro
m
th
e su
rv
ey were sho
w
n
t
h
ro
ugh
o
v
e
rall situ
atio
n as
well as co
m
p
arativ
e
anal
y
s
i
s
bet
w
e
e
n
ur
ba
n a
n
d
r
u
ral
a
r
ea’s
res
p
on
de
nt
s, a
n
d s
m
oker an
d
n
o
n
-
sm
okers.
3.1.
Socio-eco
nomic c
o
ndition
At th
is section so
cio-eco
n
o
m
ic ch
aract
eri
s
t
i
cs were
p
r
ese
n
t
e
d wi
t
h
be
hav
i
ou
r rel
a
t
e
d t
o
t
obacc
o
use
an
d
o
b
serv
ing
ad
v
e
rtisem
en
t
an
d
p
r
o
m
o
tio
nal activ
ities o
f
th
o
s
e pro
d
u
c
t
s
. Ov
erall 80% o
f
th
e respon
d
e
n
t
s
were
f
o
u
n
d
of
age
bet
w
ee
n
25
t
o
6
4
y
ears
(4
8%
was
f
r
o
m
25 t
o
4
4
a
g
es) i
n
t
a
bl
e
1.
A
b
o
u
t
15%
o
f
t
h
e
resp
o
nde
nt
s w
e
re
b
e
t
w
ee
n 15
t
o
24
y
e
a
r
s of
age. O
n
l
y
8% of
t
h
e resp
o
n
d
e
nt
s
we
re of
ab
ove
6
5
y
ear
s ol
d. Us
e
of t
o
bacc
o a
n
d
i
t
s
t
y
pes were
obs
er
ved
hi
g
h
l
y
si
gni
fi
cant
l
y
associ
at
ed
on
b
o
t
h
a
g
e an
d e
d
ucat
i
on
b
u
t
n
o
t
i
c
i
n
g
ad
v
e
rtisem
en
t
o
f
t
o
b
acco
was ob
serv
ed in
d
e
p
e
nd
en
t
o
f
t
h
o
s
e. No
ticin
g
p
r
o
m
o
tio
n
a
l activ
ities was
inde
pende
n
t
of age
but ass
o
ci
ated wit
h
e
duc
ation si
g
n
i
f
i
can
tly.
Ab
ou
t 75%
and
45
% o
f
th
e r
e
sp
ond
ents
h
a
d
at least p
r
im
ar
y an
d
secon
d
a
ry ed
u
cation
,
resp
ectiv
ely.
Abo
u
t
1
6
% of th
e respon
d
e
n
t
s
fou
n
d
illiterate hav
i
ng
no
fo
rm
al edu
cat
i
on. M
o
re r
e
sp
on
de
nt
s i
n
no
n
-
sm
okers c
a
t
e
go
ry
(5
8%)
had sec
o
n
d
ar
y
educat
i
o
n co
m
p
ared
t
o
sm
oker
’
s c
a
t
e
go
ry
(
3
6%)
.
T
obacc
o
use
was
m
o
re
prevalent am
ong pe
rsons
w
ith
no form
al education
(62
.
9
%
) and
i
n
th
e l
o
w
e
st
q
u
i
n
tiles o
f
socio
-
eco
n
o
m
ic
statu
s
(SES: 55
.6
%)
[1
7
]
.
On
an av
erag
e
1
2
,600
BD
T/m
o
n
t
h
was th
e
r
e
sp
onden
t
’
s
f
a
m
i
l
y
in
co
m
e
. Th
at is, th
e av
er
ag
e i
n
co
m
e
o
f
th
e urb
a
n ar
ea r
e
spon
d
e
n
t
was ab
o
u
t
17
,5
00 B
D
T/
m
ont
h whe
r
e i
n
ru
ral
areas was ab
o
u
t
10
,0
0
0
B
D
T
/
m
ont
h. A
v
e
r
a
g
e m
ont
hl
y
i
n
com
e
of t
h
e sm
oke
r
s
cat
ego
r
y
wa
s 12
,0
0
0
B
D
T as wel
l
as no
n
-
sm
oker’
s 14
,4
0
0
B
D
T
.
The i
n
c
o
m
e
of t
h
e
resp
o
nde
nt
wa
s
m
a
i
n
l
y
depends
o
n
b
u
si
ne
ss (4
5%
) of
d
i
ffere
nt
ki
n
d
,
agri
c
u
l
t
u
re (
1
6
%
) an
d em
pl
oym
ent
(
1
4
%
)
.
A
good
nu
m
b
er
o
f
th
em
w
e
r
e
stu
d
en
t in
p
r
esen
t situ
atio
n
.
Th
e esti
m
a
ted
n
u
m
b
e
r
of
cur
r
e
n
t
ad
u
lt
to
b
acco
sm
o
k
e
rs is 2
1
.
9
millio
n
(m
a
l
es:
2
1
.
2
and
female
s: 0
.
7
)
[17
]
, [21
]
. It is esti
m
a
ted
th
at to
tal
expe
n
d
i
t
u
re
o
n
ci
garet
t
e
s i
s
1.0%
of g
r
o
ss dom
est
i
c
p
r
o
d
u
ct
(G
DP)
and o
n
bi
di
s
i
s
0.4% o
f
GD
P i
n
Ban
g
l
ad
esh. Th
e
p
r
ice
o
f
100 p
a
ck
s
o
f
m
a
n
u
f
act
u
r
ed
cigare
ttes as a p
e
r
c
en
tag
e
of
p
e
r
cap
ita GD
P is
5% and
t
h
e p
r
i
ce
of
1
0
0
pack
s
of
bi
di
s as a
pe
rcent
a
ge
of
pe
r ca
pi
t
a
G
D
P i
s
1%
[
17]
.
Ty
pe
s
of
t
obacc
o
usi
n
g
wer
e
obs
er
ved
i
n
de
pen
d
e
n
t
wi
t
h
i
n
com
e
but
ot
h
e
r t
h
ree
vari
a
b
l
e
sh
owe
d
i
n
t
a
bl
e 1
we
re si
gni
fi
cant
l
y
ass
o
ci
at
ed
with
in
co
m
e
o
f
th
e
respon
d
e
n
t
.
Tab
l
e
1
.
So
ci
o
-
eco
no
m
i
c ch
aracteristics with b
e
h
a
v
i
o
u
r
related
to
t
o
b
a
cco
u
s
e and
o
t
h
e
r activ
ities
Using tobacco
Types of
tobacco using
Noticed
adver
tisem
ent
Noticed pro
m
o
tional
activities
Yes
No,
but
pr
eviously
using
No,
never
Sm
oked Sm
okeless
Both
Yes
No
Yes
No
Age
15-
24
32
4
26
32
0
4
56
6
38
24
25-
44
129
6
58
100
18
17
170
23
129
64
45-
64
75
9
34
46
19
19
93
25
65
53
65+ 18
9
4
15
6
6
25
6
20
11
T
o
tal 254
28
122
193
43
46
344
60
252
152
P-
value* 0.
000
0.
003
0.
076
0.
221
Education
N
o
form
a
l
education
51
4
7
26
10
19
55
7
42
20
< pr
im
ary
31
4
6
20
9
6
38
3
33
8
Pr
im
ary
35
3
3
31
5
2
39
2
26
15
< secondar
y
50
5
23
37
7
11
65
13
55
23
≥
Secondar
y
87
12
83
79
12
8
147
35
96
86
T
o
tal 254
28
122
193
43
46
344
60
252
152
P-
value* 0.
000
0.
000
0.
07
0.
003
Inco
m
e
< 5000
16
2
7
9
6
3
20
5
16
9
5000 -
100
00
124
13
35
87
20
30
158
14
128
44
1000
0 -
15000
46
6
25
39
8
5
68
9
50
27
1500
0 -
20000
21
3
14
18
3
3
33
5
17
21
≥
2000
0
20
1
20
17
1
3
30
11
20
21
T
o
tal 227
25
101
170
38
44
309
44
231
122
P-
value* 0.
035
0.
162
0.
017
0.
001
*(
[Hi
ghl
y
Si
gn
i
f
i
cant
]
p
≤
0.01
; [Sign
i
fican
t] p
≤
0.
05;
[I
nsi
gni
fi
cant
]
p
≥
0.05
)
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJPHS
Vol. 3, No. 4,
Decem
ber 2014
: 259 –
266
26
2
3.
2.
T
o
bacc
o use
Tab
l
e
2
sho
w
s th
at to
tal
4
8
% of
th
e r
e
spond
en
ts w
e
r
e
i
n
h
a
b
it
o
f
on
ly sm
o
k
i
n
g
w
h
ile
1
1
%
w
e
r
e
in
habi
t
of
usi
ng
bot
h sm
oked
a
n
d
sm
okel
e
ss t
obacc
o.
A
n
ot
h
e
r 1
1
%
we
re f
o
u
n
d
t
o
use
o
n
l
y
sm
okel
e
ss t
obac
c
o
.
Al
t
oget
h
er
5
9
%
were i
n
ha
bi
t
of sm
oki
n
g
c
u
r
r
ent
l
y
o
r
p
r
e
v
i
o
usl
y
. A
b
out
7%
of t
h
e
res
p
on
de
nt
s ha
d
gi
ven
u
p
u
s
ing
tob
acco at th
at ti
me. Si
m
ilar resu
lt was fou
n
d
that s
m
o
k
i
ng
cessatio
n
rates are relativ
ely lo
w i
n
B
a
ngl
a
d
esh
[2
1]
. AI
D [
1
7]
and
GA
TS [
2
2]
al
so sh
ows
t
h
at
nearl
y
70% o
f
cu
rre
nt
sm
okers
pl
an
or ar
e
th
in
k
i
n
g
abou
t q
u
iting
.
Ab
out 5
2
%
resp
onden
t
s w
e
re sm
o
k
i
ng
tob
acco
an
d
abou
t 30
% o
f
t
h
e respond
en
ts
were
never
us
er of any
kind tobacco. Us
e of tobacc
o and
its
types were obse
rve
d
highly signifi
cantly
associated wit
h
areas. T
h
e survey fo
und tha
t
23.0% of adult aged 15 year
s or above currently s
m
oke tobacco
in
Ban
g
l
ad
esh (
m
a
l
es: 4
4
.
7% an
d
f
e
m
a
les
:
1
.
5
%
)
[17
]
. A
bou
t 53
% and
73
% r
e
spond
en
ts
w
e
r
e
i
n
h
a
b
it of
using tobacc
o from
the urban and t
h
e rural areas,
re
s
p
ectively i.e., 63%
of t
h
e res
p
ondents
were
using
t
obacc
o.
Fr
om
G
A
TS
su
rvey
, t
h
e sm
oki
ng
rat
e
i
n
ru
r
a
l an
d ur
ban
ar
eas is 23
.6
% and 21
.3
%,
r
e
sp
ectiv
ely
[1
7]
. O
n
the cont
rary
, ab
o
u
t 40
% (u
rba
n
) and
20% (
r
u
ral)
resp
on
de
nt
s h
a
d ne
ver bee
n
use
d
t
obacc
o.
GAT
S
sho
w
s
c
u
rre
nt
t
obacc
o use (s
m
oki
ng or
sm
okel
e
ss
)
am
on
g
a
dul
t
s
i
s
43
.
3
% but
t
h
e pr
op
o
r
t
i
on
i
s
hi
g
h
er
i
n
m
a
l
e
(58.
0%)
.
M
o
re t
h
an
5
0
%
of m
e
n (n=1
3,
58
4
)
, com
p
ar
ed t
o
1%
of
w
o
m
e
n (n=2
5,
4
5
4
)
,
rep
o
r
t
e
d sm
oki
ng
at th
e ti
m
e
o
f
in
terv
iew [17
]
. Th
e
prevale
n
ce of curre
nt s
m
oking
peake
d
at the e
n
d
of the
4th deca
de a
n
d
begi
nni
ng
o
f
t
h
e 5t
h
deca
de.
T
h
e
use
of
sm
okel
e
ss t
obacc
o a
m
ong w
o
m
e
n was
hi
g
h
er
co
m
p
ared t
o
m
e
n (
2
8
%
vs 21%
)
[14]. Male sex of current tobac
c
o sm
oke
, 68.4%,
15.2%, a
nd
16.3% we
re s
m
oked t
o
bacco,
sm
okeless tobacco, and bot
h
s
m
okeless
and sm
oking tobacco, res
p
ectively. Th
e perce
n
tage of curre
nt
m
a
le
user
s
h
owe
d
54.6, 23.0, and 22.4
of
sm
oke
d
tobacc
o
only, sm
okeless tobacco m
a
inly, and both sm
okeless
and sm
oki
n
g
t
obacc
o,
res
p
ec
t
i
v
el
y
[17]
i
s
l
o
we
r rat
e
i
n
s
m
oki
ng t
o
bacc
o g
r
o
u
p
fr
om
t
h
e pre
s
ent
fi
n
d
i
n
gs.
Ov
erall 27
.2
% o
f
th
e adu
lt po
pu
latio
n curren
tly u
s
e sm
okeless tobacc
o and is m
o
re prevale
n
t in
rural areas
(2
8.
8%
) com
p
ared t
o
ur
ban
areas (
2
2.
5%)
[1
7]
.
A c
o
m
p
re
he
nsi
v
e
ba
n
on al
l
a
dve
r
t
i
s
i
ng an
d
pr
o
m
oti
o
n
red
u
ces t
o
bacc
o co
nsum
pt
i
o
n
by
about
7%
,
i
ndepe
n
d
ent
of ot
her i
n
t
e
r
v
ent
i
o
n
s
. Som
e
cou
n
t
r
i
e
s ha
v
e
seen
co
nsu
m
p
tio
n
drop
b
y
as m
u
ch
as 16
%
[2
3
]
. Of
29
% an
d
7
0
% in
itiated
t
h
eir sm
o
k
i
ng
before
1
5
and 20
years
of age
,
re
spect
ively; a
m
ong them
90%
were
re
gular and 6% we
re
occas
i
onal sm
okers. According
to GAT
S,
4
4
.77
%
o
f
m
a
le ag
ed 15
years o
r
abo
v
e
in
itiatin
g
sm
o
k
i
ng
[17
]
is lo
wer t
h
an
t
h
at of presen
t resu
lt. More th
an
hal
f
of t
h
e B
a
ngl
a
d
es
hi
m
e
n
ove
r t
h
e a
g
e
of
25 y
e
a
r
s sm
oke ci
gerat
t
e
s,
bi
di
s,
or sm
al
l
han
d
m
a
de ci
garet
t
e
s
[21
]
an
d th
is are alm
o
st si
m
i
l
a
r to presen
t st
u
d
y
. More
p
e
op
le fro
m
ru
ral
areas
(39
%
)
h
a
d
i
n
itiated
sm
o
k
i
ng
before
16 years com
p
ared to urban a
r
eas (22%). T
h
ey
s
m
oke
m
a
inly
cigarette and bidi are com
p
arable of
8
2
% an
d 17
%, r
e
sp
ectiv
ely. Ab
ou
t
47
%
o
f
ur
b
a
n sm
o
k
e
r
s
sm
o
k
e
at
least 10
ci
g
a
r
e
ttes/d
a
y
in
p
r
esen
t
obs
er
vat
i
o
n
,
w
h
ere
G
A
TS
f
o
un
d t
h
e a
v
era
g
e n
u
m
b
er o
f
ci
garet
t
e
s sm
oke
d/
day
i
s
fi
ve
[
1
7]
.
Tabl
e 2.
C
o
m
p
ari
s
o
n
of
di
f
f
er
en
t cha
r
acterist
i
cs with livi
n
g
ar
eas a
n
d
t
y
pes
o
f
t
o
bacc
o
usi
n
g
Using tobacco
Types of tobacco
using
Yes
No,
but
pr
eviously
I
was
using
No,
Never
Total S
m
oked
S
m
okeless
Both
Total
Study
area
Ur
ban 110
11
85
206
98
18
5
121
Rur
a
l 144
17
37
198
95
25
41
161
T
o
tal 254
28
122
404
193
43
46
282
P-
value*
0.
000
0.
000
*(
[Hi
ghl
y
Si
gn
i
f
i
cant
]
p
≤
0.01
; [Sign
i
fican
t] p
≤
0.
05;
[I
nsi
gni
fi
cant
]
p
≥
0.05
)
Table
3 shows
that age
of sm
oki
ng initiation is i
nde
pe
nde
n
t of
both area
and
types of
tobacco using,
b
u
t
no
ticed
adv
e
rtisem
en
t an
d
pro
m
o
tio
n
a
l activ
ities is
h
i
g
h
l
y sign
ificantly asso
ciated
with
th
ose v
a
riab
les
sep
a
rately. Tab
l
e 3
also
shows th
at in
d
i
rect ad
v
e
rtisem
e
n
t an
d
p
r
o
m
o
tio
n
a
l activ
ities in
crease sm
o
k
i
ng
is
significa
ntly associated
with a
r
ea a
n
d
t
y
pes
o
f
t
o
bacc
o
usi
n
g
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Effect o
f
In
d
i
rect Tob
a
c
co
Advertisemen
t
a
n
d
Promo
tion
Activities in
Ba
ng
lad
e
sh
(Qa
z
i
Azad
-u
z-zaman
)
26
3
Tabl
e 3.
C
o
m
p
ari
s
o
n
of
di
f
f
er
en
t cha
r
acterist
i
cs with livi
n
g
ar
eas a
n
d
t
y
pes
o
f
t
o
bacc
o
usi
n
g
Study area
Types of
tobacco using
Ur
ban
Rur
a
l
Sm
oked
Sm
okeless
Both
Age of s
m
o
k
ing i
n
itiation
less than 15
28
40
51
-
17
15-
16
17
38
50
-
5
17-
19
24
22
38
-
8
20+ 34
36
54
-
16
T
o
tal 103
136
193
-
46
P-
value* 0.
120
0.
240
Not
i
ced any cigaret
t
e
advert
isem
ent
Yes 164
180
176
31
42
No 42
18
17
12
4
T
o
tal 206
198
193
43
46
P-
value* 0.
001
0.
002
Not
i
ced any cigaret
t
e
pro
m
o
t
ional
act
i
vit
i
es
Yes 101
151
147
19
36
No 105
47
46
24
10
T
o
tal 206
198
193
43
46
P-
value* 0.
000
0.
000
H
a
s inf
l
uence on
t
eenagers (
b
oth boys & girls)
t
o
init
iat
e
s
m
o
k
ing
Yes,
I think so
173
178
164
38
42
It
m
a
y have little i
m
p
act
12
8
10
4
2
No I
don't think
21
12
19
1
2
T
o
tal 206
198
193
43
46
P-
value* 0.
205
0.
308
Indirect adver
t
ise
m
en
t &
pro
m
o
t
ional activities inc
r
e
ase s
m
o
k
ing
Yes,
I think so
158
171
156
30
43
No,
I
don't think
37
20
31
7
2
I
have no idea
11
7
6
6
1
T
o
tal 206
198
193
43
46
P-
value* 0.
042
0.
005
*(
[Hi
ghl
y
Si
gn
i
f
i
cant
]
p
≤
0.01
; [Sign
i
fican
t] p
≤
0.
05;
[I
nsi
gni
fi
cant
]
p
≥
0.05
)
One
of t
h
e f
o
cus g
r
o
u
p
s co
nsi
s
t
s
of t
w
el
ve u
n
i
v
e
r
si
t
y
st
ude
nt
s o
f
K
hul
na age f
r
o
m
22 t
o
25
p
a
r
ticip
ated
to a d
i
scu
ssion
o
n
th
e sam
e
i
ssu
es.
A
r
o
und tw
o
-
f
i
f
t
h
of
th
e p
a
r
ticip
an
ts w
e
r
e
h
a
b
itu
ated
in
sm
oki
ng. T
h
ey
st
art
e
d sm
oki
ng
fr
om
17 t
o
20 y
ear
s o
f
ag
e. O
n
an a
v
era
g
e t
h
ey
sm
oke 10 ci
garet
t
e
s p
e
r day
.
Al
o
ng
wi
t
h
t
h
e st
ude
nt
s,
di
scussi
o
n
was c
ont
i
n
ue
d wi
t
h
som
e
ot
her g
r
o
u
p
s l
i
k
e fa
r
m
er, t
obacc
o
sel
l
e
r,
ricks
h
aw/
v
an
puller, day la
bor, etc.
Anot
her
foc
u
s
group
of ten t
o
bacco seller
of Jolm
a bazar unde
r
B
a
t
i
a
ghat
a
U
p
azi
l
a
of
Kh
ul
n
a
age
fr
om
28
t
o
5
5
part
i
c
i
p
at
ed f
o
r a
n
ot
h
e
r di
sc
ussi
on
.
Ar
ou
n
d
hal
f
o
f
t
h
e
part
i
c
i
p
a
n
t
s
w
e
re sm
oker. T
hos
e w
ho
we
r
e
sm
oker st
a
r
t
e
d f
r
om
19 y
e
ars o
f
age
o
n
a
v
era
g
e.
O
n
an
avera
g
e
t
h
ey
sm
oke 1
0
ci
garet
t
e
s/
day
.
3.
3.
T
o
bacc
o use
The National
Tobacco C
ont
rol Cell (NT
CC) of th
e
Ministry of Health and Fa
mily W
e
lfa
r
e
(M
o
H
F
W) c
o
n
duct
e
d a st
udy
i
n
n
o
r
t
h
er
n
N
a
oga
o
n
di
st
ri
ct
i
n
col
l
a
b
o
r
at
i
o
n wi
t
h
WH
O t
o
e
v
al
uat
e
t
h
e
ext
e
nt
of
unl
a
w
f
u
l
T
A
PS i
n
t
h
at
d
i
st
ri
ct
. It
was not
e
d
t
h
at
advertise
m
en
t o
f
to
b
acco
pr
o
ducts th
roug
h
leaflets,
poste
rs a
nd
flyers at points
of sale are comm
on. Tob
acco
com
p
anies also offe
r
gift
s and prizes vi
olating t
h
e
l
a
w. Al
so t
h
e a
dve
rt
i
s
em
ent
s
are m
a
i
n
l
y
being
obse
r
ved at
t
h
e poi
nt
o
f
sal
e
and p
ubl
i
c
wal
l
s
[2
4]
. In
prese
n
t
st
udy
po
st
ers
were m
a
i
n
l
y
bei
ng
use
d
i
d
e
n
t
i
fi
ed by
7
8
%
of th
e
resp
ond
en
ts as a
p
a
rt of adv
e
rtisem
en
t in
ru
ral
areas w
h
ere
pa
cket
wal
l
(6
0
%
) was
bei
n
g
use
d
m
a
i
n
l
y
as a part
o
f
ad
ve
rt
i
s
em
ent
i
n
ur
ban
fo
r m
a
rket
i
ng
of
their tobacco
products. Little diffe
rence was observed i
n
prom
otiona
l activities between urba
n a
n
d rural
areas. Free sam
p
les were b
e
in
g
g
i
v
e
n
m
a
in
l
y
as p
r
o
m
o
tio
nal activ
ities. C
l
o
t
h
i
ng
item
s
a
n
d
co
upo
ns were also
b
e
ing
u
s
ed
as a p
a
rt of
p
r
o
m
o
tio
n
a
l activ
ities
in
ru
ral
a
r
eas.
Sm
okers w
e
re
ob
ser
v
e
d
m
o
re l
i
k
el
y
t
o
n
o
t
i
ced ad
vert
i
s
e
m
ent
and
p
r
o
m
oti
on c
o
m
p
ared t
o
no
n-
sm
okers. T
h
e
r
e
sp
on
de
nt
s f
r
o
m
bot
h cat
eg
o
r
i
e
s ha
d
n
o
t
i
ced
post
e
rs
(6
5
%
),
pac
k
et
wal
l
(5
2%)
,
a
n
d
b
i
g si
ze
packet
s (
3
8%
)
as t
h
e
m
a
i
n
m
e
t
h
o
d
s o
f
ad
ve
rt
i
s
i
ng o
f
t
o
ba
cco p
r
o
d
u
ct
s and s
o
m
e
on l
i
ght
e
r
(2
1%
), fi
re b
o
x
(17%
), a
nd sy
m
bol (10%
). T
h
ey ha
d notice
d
point
of sa
le
(84%
) and
public walls (25%) as the m
a
in place for
adve
rt
i
s
em
ent
of t
obacc
o
pr
o
duct
s
. G
A
TS
s
h
o
w
t
h
at
ove
ra
l
l
38.
4% a
dul
t
s
(cu
rre
nt
sm
okers
5
6
.
1
% a
n
d n
o
n
-
sm
okers 33.0%)
noticed cigarettes m
a
rk
eting in st
ores
where ci
garettes
are
s
o
l
d
[1
7]
. Few of
t
h
em
fr
om
bot
h
th
e categ
ories
h
a
d
also
no
ticed
pub
lic tran
spo
r
tation
(9
%)
[Section
2(g) “
P
ublic Transport” m
eans
m
o
tor ca
r,
bus
, t
r
ai
n, t
r
u
m
, shi
p
, l
a
u
n
c
h
, al
l
ki
nds
of
m
echani
zed
p
u
b
lic tr
an
sp
or
t, air
c
r
a
f
t
and an
y o
t
h
e
r
tr
an
spor
t
determ
ined or
declare
d
by the Govern
m
e
nt by notification in t
h
e
Official
Gazette] [1] a
s
one
of the
place of
those activities. A ne
gligible
num
ber of
responde
nts ha
d mentione
d cine
ma
(3%) a
nd i
n
ternet (1%
)
as a place
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJPHS
Vol. 3, No. 4,
Decem
ber 2014
: 259 –
266
26
4
o
f
adv
e
rtisem
e
n
t activ
ities in p
r
esen
t
ob
serv
atio
n.
AID
[2
2
]
, i
n
a
b
a
sel
i
n
e
surv
ey, sho
w
s th
at
3
2
%
o
f
t
h
e
p
u
b
lic tr
an
spor
t u
s
er
s
do
not k
now
wh
at i
s
pu
b
lic
p
l
ace
and
public trans
p
ort.
Nearl
y
half
of t
h
e
adult
po
p
u
l
a
t
i
on
(4
9
.
8%
) n
o
t
i
ced a
n
t
i
-
sm
oki
ng
i
n
fo
rm
ati
on, m
o
st
l
y
on ra
di
o a
nd t
e
l
e
vi
si
on
(
4
0
.
5
%
).
Peo
p
l
e
i
n
t
h
e
hi
g
h
est
SE
S
(6
8.
4%)
we
re m
o
re
ex
p
o
sed
t
o
ant
i
-
sm
oki
n
g
i
n
f
o
rm
at
i
on co
m
p
ared t
o
t
h
e
l
o
west
SES
(
3
0.
8%)
.
C
i
garet
t
e
adve
rt
i
s
i
ng, s
p
ons
o
r
shi
p
o
r
pr
om
ot
i
on
was n
o
t
i
ced by
nearl
y
hal
f
of t
h
e
po
p
u
l
a
t
i
on (
4
8
.
7%
).
Am
ong
sm
oke
rs, 51.6% noticed
health wa
rnings on
ci
gare
t
t
e packa
g
es; 74.4% of th
em
thought a
b
out quitting
sm
oki
ng
beca
use
of t
h
ose
war
n
i
n
gs
[1
7]
.
Nearl
y
7
0
%
of c
u
r
r
e
n
t
sm
oke
rs
were
pl
an o
r
t
h
i
nki
ng
abo
u
t
q
u
ittin
g.
Alm
o
st h
a
lf
o
f
sm
o
k
e
rs (4
7.3%)
mad
e
an
attemp
t to
qu
it in
the last 1
2
m
o
n
t
h
s
.
Am
o
n
g
those who
v
i
sited
a h
ealth-care facility,
56
% were ask
e
d
abo
u
t
t
h
eir
h
i
sto
r
y of t
o
b
acco sm
o
k
i
n
g
and
52
.9
%
were advised
to
qu
it sm
o
k
i
ng
.
Of tho
s
e
wh
o atte
m
p
ted
to
q
u
it during
th
e p
a
st
12
mo
n
t
h
s
,
14
.9
%
u
s
ed
coun
seling
an
d
14.5% use
d
ot
her m
e
thods,
whic
h includes
traditional
m
e
dicines [17]. T
h
e prom
o
tional
activities had
m
a
inly
b
een
no
ticed
free sam
p
les (5
1%) and
g
i
fts (43
%
). Free samp
les as a
p
a
rt
of pro
m
o
tio
n
a
l
activ
ities h
a
d
main
ly
been
n
o
t
i
ced b
y
t
h
e sm
okers
.
Som
e
of t
h
e r
e
sp
on
de
nt
s ha
d al
so
not
i
ced
cou
p
o
n
s
(
1
%)
,
cl
ot
hi
n
g
i
t
e
m
s
wi
t
h
l
o
g
o
(2%
)
,
an
d
di
sc
ou
nt
on
ot
her
g
o
ods
(
2
%
)
as
wel
l
.
3.4. E
ffec
t
of adver
t
isement
and pr
omotional
acti
vities
Mo
re th
an
80% o
f
respo
n
d
e
n
t
s th
oug
h
t
that th
e in
d
i
rect
ad
v
e
rtisem
en
t
an
d
p
r
o
m
o
tio
n
a
l activ
ities
i
n
creases sm
oki
n
g
an
d rem
a
i
n
i
ng
no e
ffect
s on sm
oki
n
g
.
Aft
e
r t
h
at
t
h
e
resp
on
de
nt
s were as
ked a
b
out
t
h
e
norm
aliz
ing effects of advert
ise
m
en
t on tobacco products. About 87%
of
the re
sponde
nts thought activities
in
flu
e
n
c
ed
o
n
teen
ag
ers t
o
in
it
iate s
m
o
k
i
ng
.
Tab
l
e
4
.
Effect of ad
v
e
rtisemen
t and
pro
m
o
tio
n
a
l activ
ities
Influence on teenagers to initiate
Increase s
m
oking
Yes, I think
so
I
t
m
a
y
have
little i
m
pac
t
No I
don't
think
Yes, I think
so
No,
I
don't
think
I
have no idea
Noticed tobacco
advertise
m
ent
Yes 302
14
28
289
47
8
No 49
6
5
40
10
10
T
o
tal 351
20
33
329
57
18
P-
value* 0.
146
0.
000
Noticed
tobacco p
r
o
m
otional activit
i
es
Yes 219
12
21
216
33
3
No 132
8
12
113
24
15
T
o
tal 351
20
33
329
57
18
P-
value* 0.
965
0.
000
*(
[Hi
ghl
y
Si
gn
i
f
i
cant
]
p
≤
0.01
; [Sign
i
fican
t] p
≤
0.
05;
[I
nsi
gni
fi
cant
]
p
≥
0.05
)
M
o
re
resp
o
n
d
e
nt in r
u
ral ar
eas
com
p
ared to urba
n a
r
ea
s (urb
an
:
8
4
%
an
d
ru
ral: 90%) tho
ugh
t
ad
v
e
rtisem
en
t
an
d
p
r
o
m
o
tio
nal activ
ities
in
flu
e
n
c
ed
teen
agers to
in
itiate
sm
o
k
i
n
g
.
Abou
t 1
0
%
o
f
th
e
u
r
b
a
n
p
e
op
le and
6% o
f
th
e
rural peo
p
l
e (ov
e
rall: 8
%
)
h
a
d
t
h
e op
po
site op
in
ion
.
Few of th
em
m
e
n
tio
n
e
d
ch
ild
ren
bef
o
re t
e
e
n
age
as wel
l
as wom
e
n are al
so bei
n
g ent
h
ral
l
ed i
n
usi
ng t
obacc
o
pr
od
uc
t
s
. The ot
her
effect
s
id
en
tified
b
y
th
e resp
ond
en
ts were to
ob
tain
n
e
w brand
s
(urb
an
: 44
% an
d
rural: 4
3
%
), h
e
lp
to
g
e
t sm
o
k
i
n
g
tobacc
o
products easily (urban:
20%
and rural:
37%)
as
well
as
it had effect
t
o
normalize
s
m
oking tobac
c
o
pr
o
duct
s
l
i
k
e
o
t
her c
o
n
s
um
er pr
o
duct
s
(u
r
b
a
n
:
2
4
% a
n
d r
u
r
a
l
:
34%
).
Ab
o
u
t
8
0
%
of
t
h
e
resp
o
nde
nt
s sa
i
d
t
h
at
th
e adv
e
rtisemen
t and
pro
m
o
tio
n
a
l activ
ities sh
ou
l
d
no
t b
e
co
n
tinu
e
d
.
Ov
erall 1
0
%
of th
e
respon
d
e
n
t
s (urb
an
:
7
%
an
d ru
ral:
1
2
%) t
h
ink
th
ere was no
proble
m
to
co
n
tinue to
b
acco
adv
e
rtise
m
en
t an
d
p
r
o
m
o
tio
n
a
l activ
ities.
Tab
l
e 4 shows th
at no
ticed
t
o
b
acco
adv
e
rti
s
em
en
t an
d
pro
m
o
tio
n
a
l activ
ities are in
si
gn
ifican
tly associated
with
in
fl
u
e
n
c
e o
n
teen
ag
ers to
in
itiate s
m
o
k
i
ng
sep
a
rate
ly b
u
t
h
i
gh
ly sig
n
i
fican
tly asso
ciated
with
i
n
crease
sm
oki
ng.
4.
CO
NCL
USI
O
N
M
o
re t
h
an
hal
f
o
f
a
dul
t
m
a
l
e
were
o
b
se
rve
d
sm
oker an
d a
h
uge
n
u
m
b
er
of
t
h
em
had st
art
e
d sm
oki
n
g
at teenage. Pe
ople of rural a
r
eas ha
d initiated sm
oki
ng ea
rlier com
p
ared to ur
ban areas. Tobacco C
o
m
p
an
y
mainly used point of sale
as
the place for a
dve
rtising and
the res
p
onde
n
ts
ha
d
noticed on poster followed by
p
ack
et
wall and
b
i
g
size p
a
cket as in
d
i
rect ad
v
e
rtisem
en
t. Th
e
p
r
o
m
o
tio
n
a
l activ
ities h
a
d
m
a
in
ly b
een
n
o
ticed
free sam
p
l
e
s o
f
t
obacc
o a
nd
gi
ft
s. Tee
n
a
g
er
s were
get
t
i
ng
i
n
t
e
rest
an
d be
com
i
ng sm
oke
r seei
n
g
an
d fe
el
i
n
g
th
e adv
e
rtisemen
t and
pro
m
o
tio
n
a
l ac
tiv
ities.
Research
can
b
e
d
o
n
e
on
t
h
e d
e
term
in
in
g
factors o
f
b
e
co
m
i
n
g
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Effect o
f
In
d
i
rect Tob
a
c
co
Advertisemen
t
a
n
d
Promo
tion
Activities in
Ba
ng
lad
e
sh
(Qa
z
i
Azad
-u
z-zaman
)
26
5
sm
o
k
e
rs o
t
h
e
r
th
an
adv
e
rtisemen
t an
d pro
m
o
tio
n
a
l acti
v
ities and
h
o
w t
o
min
i
mize an
d
d
i
scou
rag
e
t
h
em
fro
m
using tobacco
products. M
o
re adva
nced st
udies are nee
d
e
d
in de
pth on tobacc
o control
issues in Khulna as
well as in Bang
lad
e
sh
.
ACKNOWLE
DGE
M
ENTS
The a
u
t
h
or
wi
shes t
o
e
x
p
r
ess
grat
ef
ul
ne
ss an
d t
h
a
nks t
o
t
h
e
B
a
ngl
a
d
esh C
e
nt
er f
o
r C
o
m
m
uni
cat
i
o
n
Program
(BC
C
P) and
Institu
te for Glob
al
To
b
acco
Contro
l (IGTC)
based
on
John
s Hop
k
i
n
s
Bloo
m
b
erg
Sch
ool
o
f
P
u
bl
i
c
Heal
t
h
fo
r
fi
nanci
a
l
s
u
pp
ort
t
o
ca
rry
out
t
h
e resea
r
ch
.
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I
S
SN
:
2
252
-88
06
IJPHS
Vol. 3, No. 4,
Decem
ber 2014
: 259 –
266
26
6
BIOGRAP
HI
ES OF
AUTH
ORS
I, Qaz
i
Az
ad-u
z-zam
an
, re
ce
iv
ed a
res
e
arch
grant
joint
l
y
fr
om
Banglades
h
Cent
er for
Com
m
unication Program
(BCCP) and Institute
fo
r Global Tobacco Control (IGTC) based on
Johns Hopkins
Bloomberg School of
Public Health as MPH St
udent of Northern University
Banglad
esh in 2013. Prior to th
at m
y
gradu
a
tio
n in Statistics from the University
of Dhak
a
was completed
.
Soon after I started doing r
e
sear
ch on environmen
tal
issues focusing on urban
and rural livelih
ood. As a member of the Japa
n
Association of Drainage
and Environment,
Banglad
es
h (J
ADE-B) I am
im
plem
enting d
e
vel
opm
ent act
ivit
ie
s
and res
earch
to
im
prove the
living env
i
ronment of urban slu
m
s of
Khulna ci
t
y
as well as p
a
rti
c
ipa
ting to n
a
tion
a
l and
intern
ation
a
l s
c
i
e
ntifi
c
confer
enc
e
s to pr
esent
e
d r
e
search
ar
tic
le
.
I, Quazi Zah
a
ng
ir Hos
s
a
in, am
the P
r
ofes
s
o
r
of Environmental
Scienc
e Discipline, Khulna
Universit
y
as well
as Adjun
c
t
Facult
y,
Dep
a
r
tme
nt
of Publ
ic
He
a
l
t
h
,
Nort
he
rn Uni
v
e
r
sity
Banglad
esh, Kh
ulna Campus an
d a member of d
i
fferen
t
learn
e
d
bodies.
Teachin
g
and r
e
sear
ch
have contr
i
buted
to write books and about 30 res
earch articles jointly
with oth
e
r research
er
which has been published to different in
te
r
n
ation
a
l and n
a
tion
a
l journa
ls. Current
l
y
s
upervis
ing two P
h
D s
t
udents
.
Recen
tl
y be
com
e
inter
e
s
t
ed in h
e
a
lth rel
a
t
e
d is
s
u
es
and bein
g
involved
in r
e
search
and
consultation
.
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