Background:Despite legal restrictions on tobacco advertising, social media platforms have emerged as largely unregulated spaces for indirect tobacco promotion. Image-based networks such as Instagram intensify this threat through visibility, influencer marketing, and normalization of smoking among youth. This study analysed the prevalence and nature of smoking imagery on Instagram to assess patterns of sentiment, product portrayal, and policy violations. Methods:A content analysis of 750 Instagram posts containing fifteen smoking-related hashtags was conducted between February and May 2023. An eight-domain codebook classified posts by sentiment, artifact visibility, tobacco use, smoke play, health warning, anti-smoking awareness, brand promotion, and artifact type. Descriptive statistics were generated using SPSS v25, and WordCloud analysis identified recurring themes. Results:Posts demonstrated high visibility and engagement (mean likes: 361.8±607.5; comments: 12.7±18.8; user followers: 17,262±48,138). Positive sentiment dominated (79.7%), while negative sentiment was rare (0.9%). Smoking artifacts were visible in 75.6% of posts, with explicit tobacco use in 61.9%. Smoke play appeared in 20.3%. Brand promotion was present in 22.3% of posts. Health warnings (2.8%) and anti-smoking intent (1.5%) were less common. Cigarettes were most common (61.2%), followed by ENDS (17.9%), marijuana (8.2%), and hookah (6.8%). WordCloud analysis revealed four themes: gendered smoking identity, fetishization, cultural pairing, and increasing vaping imagery. Conclusion:Smoking is widely normalized and aesthetically portrayed on Instagram, with substantial engagement and covert brand presence despite regulatory bans. Limited health messaging and strong visual messaging highlight gaps in digital tobacco control, emphasising the need for strengthened tobacco control regulations and active social media surveillance.

BACKGROUND:Tobacco industry tactics that have proven effective in the past, such as using corporate social responsibility initiatives to curry favour with policymakers, have been examined in India. However, reporting the tobacco industry's financial contributions to political parties must be closely monitored, and their reporting made transparent. METHODS:Document analysis was conducted for: (i) 'recognised' national and state political parties in India (as on 15 May 2023), (ii) Electoral Trusts listed by Central Board of Direct Taxes, and (iii) Electoral Bonds, available from the Election Commission of India (ECI) website. Annual contributions from top four publicly listed companies (Bombay Stock Exchange 'Top 2000 Companies 2023') and one major non-listed smokeless tobacco company-along with their subsidiaries, associates and joint ventures-were examined. Contribution pathways included direct transfers or indirect routes via Electoral Trusts and Electoral Bonds, spanning 2013-2014 to 2022-2023. RESULTS:A total of 485 (62.2%) of the 780 expected reports of parties and Trusts were available on ECI website. These were analysed for contributions by 103 tobacco companies and their affiliated entities. Tobacco companies had contributed more than US$ 65 million to 17 political parties between 2013 and 2023. The largest contributors were ITC Limited and its subsidiaries-ITC Infotech India and Russell Credit. CONCLUSIONS:This study documents a less-discussed area in the Indian landscape of tobacco industry interference and highlights the pressing need for comprehensive implementation of the WHO-Framework Convention on Tobacco Control Article 5.3, to prohibit financial contributions by tobacco companies to political parties in India, and ultimately protect public health.

India experiences a high degree of tobacco industry interference. The World Health Organization Framework Convention on Tobacco Control, in its Article 5.3, requires members to protect their policies from tobacco industry influence. Despite the global guidance, the implementation of the Article 5.3 of the convention remains far from desired. We study implementation processes concerning the Article 5.3 policies in 17 of the 19 Indian states that had adopted such policies by 2023. We first conducted an online survey to understand the nature and enforcement of Article 5.3 policies. We then conducted focus group discussions engaging representatives from governments and civil society. The inquiry focused on understanding the prevailing policies, perceived challenges, and good practices in policy implementation as well as the perceived policy impacts. We used reflexive thematic analysis of the qualitative data. There were 17 respondents for the survey, and a total of 258 participants in 17 focus group discussions across study states. Major perceived challenges in the implementation of Article 5.3 policies included limited dissemination/awareness about these policies, suboptimal functioning of the committees overseeing implementation, low priority accorded to these policies, and interference by the tobacco industry. Several government departments were perceived vulnerable to industry interference, with the departments of education, health, and municipal administration perceived as the most vulnerable. A few states adopted practices that facilitated Article 5.3 policy implementation, including display of policy signage/declarations, issue of policy orders/notifications by non-health departments, and setting up a complaints mechanism and norms to avoid sponsorships by private entities. These policies were perceived to have reduced visible interference from the industry and enabled some of the government agencies to refuse funding/partnerships with the tobacco industry. The sub-national Article 5.3 policies in India have a promise to reduce tobacco industry interference. However, implementation of these policies ought to be strengthened.

Abstract Objective: To strengthen the WHO-Framework Convention on Tobacco Control (FCTC) MPOWER “warn” component, India implemented 85% pictorial health warnings (PHWs) on all tobacco packs in 2016, allowing a two-month grace period to clear old stock. We monitored compliance and the time taken to comply with the revised PHW rules effective December 1, 2020, during December 2020–May 2021. Methods: A cross-sectional survey assessed one prominent tobacco point-of-sale (PoS) in each of 21 cities across nine Indian states, with 24 follow-up visits. A “saturation approach” measured the weeks required for full adoption of new PHWs, with product and brand analyses conducted across all cities. Results: Tobacco companies took an average of 10 weeks to comply with PHW regulations for 399 products, exceeding the two-month legal limit. None of the surveyed cities attained both complete saturation and full regulatory compliance across all three tobacco product categories. Saturation in the first week of the observation was achieved by cigarette brands (“One and Only and Moments” ), smokeless tobacco brands (“ Eagle, and Gopal 100”) , and bidi brands (“ Desai bidi, Dinesh bidi, and Naresh bidi”) . Conclusions: Tobacco companies in India are non-compliant with the new PHW rules 2020, with diverse regional saturation trajectories. This clearly makes a case for the non-compliant industry behavior toward Indian regulations. There is a need to strengthen enforcement and reduce discrepancies across various city-states to ensure that the grace period is not violated by the tobacco companies.

Introduction Numerous guidelines have been developed worldwide to support healthcare professionals in providing evidence-based interventions to help individuals quit smoking and other forms of tobacco use. The evaluation of the quality of the guidelines of tobacco cessation is however deficient and lacking. Methodology PubMed, Embase, Scopus and Cochrane Databases were electronically searched. Additional search was carried out in National Institute for Health Care Excellence, Guidelines International Network, Google Scholar and references of relevant articles to screen studies relevant to this review. Guidelines on both health and allied health professionals in English language were included. The assessment of the guidelines in this review was carried out using the AGREE II instrument by four appraisers. Results Twenty guidelines were included in this review. A comparative evaluation of all the guidelines revealed consistently higher scores in clarity of presentation domain (74.4 ± 20.9) followed by scope and purpose (65.23 ± 17.19), stakeholder involvement (63.84 ± 18.29) and rigour of development domain (61.76 ± 20.24). Lower scores were reported in Applicability (59.18 ± 18.02) and least in Editorial Independence domain (58.29 ± 19.36). Conclusion Further guidelines developed should address the gaps identified in this review and be both evidence-based and feasible to implement in diverse clinical contexts.

Background We did a retrospective secondary analysis of 1-year data of a tobacco cessation clinic (TCC) to assess correlates of nicotine dependence among tobacco users visiting the TCC at a tertiary care dental hospital. Methods Secondary data were obtained from the records of patients who had visited the TCC from January to December 2019. Of the 1436 records, 1144 were found to contain all the information needed for the study. Patient records were obtained from a pre-validated standard TCC patient assessment sheet (PAS), which included various sections: Sociodemo-graphic items, tobacco use profile items, nicotine dependence status, strategy used for cessation and follow-up details. Results Of the 1144 proformas, 97.1% (n=1111) were of men and 2.9% (n=33) were of women. Around 48.5% had medium nicotine dependence followed by high nicotine dependence (29.7%) and low nicotine dependence (21.8%). The mean (SD) age of initiation of tobacco use was 26.1 (9.44) years and a significantly lower age of initiation was observed in patients with high nicotine dependence. Greater number of years of tobacco use was significantly associated with high nicotine dependence. About 47% of patients had attempted to quit tobacco in the past and the quitting attempts were found to be significantly higher in patients with high dependence. Conclusion We explored crucial determinants of nicotine dependence among tobacco users reporting to the TCC. These factors may be incorporated in routine assessment of the tobacco use status and may be used in tailored cessation counselling strategies.

Background: Due to the high transmissibility of COVID-19, the government has implemented certain precautionary measures aimed at flattening the curve of infection and limiting the spread of the disease. Personality traits of an individual have been found as one of the main determinants that might affect adherence to preventive personal practices. Aim: This study aimed to assess the role of personality traits in adherence to COVID-19 precautions among the patients attending outpatient department (OPD) in a tertiary care dental hospital in Delhi. Methodology: A cross-sectional questionnaire survey was conducted among 400 participants aged 15–70 years attending the OPD of a public sector tertiary care dental hospital in New Delhi. A convenience sampling technique was utilized to collect the data for 2 months’ period. A self-administered validated questionnaire was used to record demographic variables, COVID-19-related status, personality traits (using 20-item Mini-International Personality Item Pool), and self-reported adherence to COVID-19 precautions. The association between personality traits with precautionary behaviors and demographic factors was analyzed using the Mann–Whitney U-test, Kruskal–Wallis test, and Spearman correlation. Results: Of the 400 participants, 193 were male and 207 female. Participants belonging to the 20–34 years of age group (44.3%), high income (<99,931 INR, 51.3%), and professionals-semiprofessional’s occupation (9%) were more adherent to COVID-19 precautions. A significant association was found between personality traits with education status (agreeableness, P = 0.017 and imaginative, P = 0.007) and gender (neuroticism, P = 0.03). Regarding the potential influence of Big Five personality traits, only conscientiousness shows a statistically significant association with adherence to COVID-19 precautions (P < 0.001). Conclusion: This study concluded that only personality factors such as conscientiousness and demographic variables such as age, income, and occupation are directly associated with greater adherence to COVID-19 precautions.

Background:Oral diseases are a silent epidemic. Objectives:The objectives of the study were to develop, validate, and assess the usability of an oral health prototype mobile application for oral health promotion among pregnant women in India. Materials and Methods:A cross-sectional study was conducted in Tertiary Care Hospital in Delhi, India, after obtaining Ethical Clearance from the Institutional Ethical Committee Board. The study was conducted in three phases: development of the prototype app, its validation, followed by usability testing of the app. Mobile app was validated by 30 pregnant women and 30 subject experts using Heuristic Analysis Scale and usability testing by 30 pregnant women based on System Usability Scale (SUS). Data were analyzed with IBM SPSS version 21.0. Results:Majority (over 90%) of pregnant women and subject experts strongly acknowledged that the app educated the users using positive motivation strategies, instilling comprehensive knowledge and faced no issues with the appropriate functionality of the app. The prototype app scored 73.75 on SUS, indicating high usability. Conclusion:This study holistically explored various dimensions of oral health care in pregnant women. Its novelty is proven by the fact that the content of the prototype application has been phase wise developed and validated by pregnant women and subject experts. Usability testing of the app indicated its high acceptability and ease of use among pregnant women in India.

BackgroundHealth technology assessment (HTA) is the systematic evaluation of various properties and effects of a health technology. HTA can serve as a bridge between the world of knowledge and that of decision making, offering decision makers the best summary of scientific evidence. Scoping HTA reports in the context of dentistry can help researchers identify grey areas; help practitioners make evidence-based decisions and further initiate better policy making. AimTo provide an overview on HTAs pertaining to oral health and dentistry in the past decade, map the extension and scope of the methodological practices, key findings, and limitations. MethodologyA scoping review was conducted using the Joanna Briggs Institute framework. A comprehensive search for HTA reports was done through the International Network of Agencies for Health Technology Assessment Database from January 2010 to December 2020. Consecutively, electronic databases (PubMed and Google Scholar) were searched. Finally, thirty-six reports were included in this review and analyzed. ResultsA total of 709 articles were initially identified, of which thirty-six met the inclusion criteria. Reviewed HTAs focused on various specialties of dentistry worldwide. Maximum number of reports (N = 5) were related to "prosthodontics and dental implants" and technologies related to preventive dentistry were most commonly assessed (N = 4). ConclusionFunctional, appropriate, and evidence-based information provided through HTA pertaining to oral health on a regular basis will enable decision makers to have enough data to make decisions on the future use of new technology, modify existing policies, accelerate its translation into practice, and ensure provision of robust dental healthcare services.

BackgroundIn the COVID-19 pandemic, vaccination is recognized as a global public-health goal for preventing, containing, and stopping transmission. But the reluctance of people to receive safe and recommended available vaccines (i.e., vaccine hesitancy) was a growing concern. One of the key elements that influence how people are perceived and their reluctance to get the COVID-19 vaccine was found to be personality traits. Hence, the aim of the study was to assess the influence of personality traits on perception and hesitancy towards COVID-19 vaccination among patients attending tertiary dental care hospitals in Delhi.MethodologyA cross-sectional questionnaire survey was conducted among a sample of 322 participants aged 15-70 years attending the outpatient department of a public sector tertiary care dental hospital in New Delhi. Data was collected over a two-month period using a validated self-administered questionnaire which recorded demographic variables, individual perceptions, hesitancy towards COVID-19 vaccination, and personality traits [using 20-item mini international personality item pool (IPIP)]. Descriptive analysis followed by a Chi-square test and correlation test was applied.ResultsA total of 322 participants were contacted among which 300 participants (93%) responded which comprised 157 males (52.3%) and 143 females (47.7%). Dominant agreeableness personality shows a statistically significant positive correlation with individual perception (r=0.124, p=0.032) while a negative correlation with vaccine hesitancy (r=-0.146, p= 0.011). Among reasons for vaccine hesitancy, fear of side effects showed a significant association with personality traits (p= 0.018).ConclusionThis study concluded that personality trait (dominant agreeableness) was an important factor in shaping individual perception and hesitancy towards COVID-19 vaccination.

Introduction Halitosis (oral malodor) is a common health condition throughout the world. In India, data on self-reported halitosis and related factors is limited. Mouth mask usage has been made compulsory after the coronavirus disease 2019 (COVID-19) pandemic. This could possibly alter oral microflora and environment and contribute to halitosis. The aim of the study was to determine the prevalence of self-perceived halitosis (SPH) among mask-wearing patients visiting a tertiary care dental hospital in Delhi, India. Methods A cross‑sectional study was conducted among a convenience sample of 300 patients visiting a tertiary care dental hospital in the capital of India. SPH status was measured using a self-designed and structured questionnaire containing socio-demographic factors, mask-related habits, and self-perceived oral health status. Statistical analysis was done using Jamovi software (The jamovi project, Sydney, Australia) version 1.8. Descriptive analysis followed by a chi-square test and a multivariate logistic regression test was applied. Results Bad breath was perceived by 86 study subjects. Of the participants, 16.7% felt that they had bad breath before the pandemic, and 38% of the participants had an increased perception or feeling of bad breath since regular mask usage. Of the participants, 42.7% felt that they had an increased feeling of dryness in the mouth post-pandemic. SPH status was associated with mask usage frequency (p<0.001), change (p<0.001) and type of mask (p=0.004), increased feeling of dryness (p<0.001), frequency of toothbrushing (p<0.001), self-reported oral disease (p=0.007), and dental treatment in the past 12 months (p=0.005). Conclusion The SPH status of the study population was associated with mask-related habits and self-reported oral health status. The findings highlight the importance of possible amendments in preventive and curative care for patients with halitosis post-COVID-19 pandemic.

BACKGROUND: Tobacco is one of the biggest threats to the public health. Tobacco harms not only human health but also the environment. The Cigarette and Other Tobacco Products Act (COTPA) was implemented in India in 2003. Compliance of these laws in public places is mandatory. This study presents an innovative model to make hospitals tobacco-free. The aim is to assess the effectiveness of implementation of tobacco-free hospitals among security guards, tobacco users, and key observers visiting a tertiary care dental hospital through a comprehensive strategy. MATERIALS AND METHODS: An exploratory study was conducted in three phases. Structured training was organized for all security guards (n = 25) along with pre- and post-assessment using a validated questionnaire. All the patients and attendants entering the hospital were screened for tobacco products by security guards. Those patients who were carrying tobacco products to the hospital (n = 107) were interviewed using a validated questionnaire. Opinions of key observers (n = 223) who witnessed the event were also recorded. Descriptive statistics (means, frequency distribution) and inferential statistics (Chi-square test) were calculated. RESULTS: At the baseline, only 20% security guards were aware about tobacco legislations, whereas after 1 month, more than 80% security guards were aware about the laws. Around two-third of study participants of both the groups were aware of COTPA Section 4. Approximately 33.6% of tobacco users and 58.4% of key observers were aware of COTPA Section 6b. Forty tobacco users in the study availed tobacco cessation services of the hospital. CONCLUSION: Every staff should be a torch bearer of tobacco control. The study highlights a comprehensive approach of integrating hospital staff and linking vital cessation services by implementing Sections of COTPA.

INTRODUCTION Increasing affordability, accessibility and penetration of internet services worldwide, have substantially changed the ways of gathering health-related information. This has led to the origin of concept infodemiology that allows the information to be collected and analysed in near real time. Globally, oral diseases affect nearly 3.5 billion people; thus, volume and profile of oral health searches would help in understanding specific community dental needs and formulation of pertinent oral health strategies. AIM To review the published literature on infodemiological aspects of oral health and disease. METHODOLOGY This scoping review was conducted in accordance with PRISMA-ScR guidelines. Electronic search engines (Google Scholar) and databases (PubMed, Web of science, Scopus) were searched from 2002 onwards. RESULTS Thirty-eight articles were included in this review. The infodemiological studies for oral health and disease were mainly used in two domains. Out of 38 articles, 24 accessed the quality of available online information and 15 studied online oral health-related information seeking behaviour. CONCLUSION The most commonly searched oral diseases were toothache, oral cancer, dental caries, periodontal disease, oral maxillofacial surgical procedures and paediatric oral diseases. Most of the studies belonged to developed countries and Google was the most researched search engine.

Background: National legislation (COTPA) in India has focused on school children with dedicated section (6a and 6b) for tobacco control at Educational Institutions. Innovative mediums like Comic offer unique and engaging medium for dissemination of health information. However, its true potential remains unexplored in tobacco control. The study was conducted to develop and validate Comic for promotion of tobacco control laws in school settings. Materials and Methods: The present cross-sectional study was conducted among school teachers in Delhi in three phases: (1) need assessment, (2) development of Comic, and (3) validation (face/content validity by experts in public health/tobacco control, and construct validity by school teachers). Ethical clearance was obtained from Institutional Ethical Review Board. Prevalidated, structured, close-ended, and self-administered Questionnaire was used for the data collection. SPSS version 21 was used for descriptive and inferential results. Results: Phase 1 showed, out of 150 school teachers, 121 participated (80.66%). Mean age and teaching experience was 41.85 ± 9.76 years and 10.35 ± 6.53 years, respectively. Overall awareness about COTPA was 47.9% (n = 58) and COTPA sections 4 and 6 were 37.2% (n = 45). Majority 59.5% (n = 72) reported lack of access to training material. Phase 2 and 3 showed overall content validity index (CVI) score of 0.84. Construct validity evaluation from pre–postintervention yield mean ± SD scores of 3.94 ± 0.99 and 7.97 ± 1.17, respectively, (P < 0.001). Conclusion: Comic was developed on sound theoretical basis with satisfactory face, content and construct validity, to raise awareness about tobacco control among school children, and teachers to promote tobacco-free school.

Oral diseases and non-communicable diseases (NCD) share modifiable risk factors and common social determinants, thus creating new opportunities for improving oral health. The existing primary health care workers can play an integral role in NCD and oral health care integration by creating awareness, promoting oral health, controlling risk factors, and referring for timely dental care. This study aimed to identify and understand the roles of the existed human health resources working at primary health care and develop strategies to build on a unified NCD and oral health alliance human resources at this level. A scoping review was conducted to identify the primary health workforce in the Southeast Asia region, their roles and responsibility, and integration in oral health care. Various databases like NCBI (PubMed), Google Scholar, World Health Organisation (WHO)-Southeast Asia region (SEAR), Ministry of Health and Family Welfare websites in SEAR were comprehensively searched from January 1980 to December 2020 for reports, reviews, and original research. The keywords used were "primary health care workers," "community health care workers," "primary oral health care in SEAR," etc. Only full-text articles in English language and reports available in Ministry of Health and Family Welfare (MOHFW) sites of SEAR were included in the study. Information was taken from 39 full-text articles, six WHO reports, and two reports from Ministry of Health sites of SEAR. Primary health workers (PHW) are known by multiple names in different countries of Southeast Asia. They share various common roles and responsibilities. There are many opportunities for the prevention and control of oral diseases in the SEAR. Basic systems and human resources for the control of NCD are in place in many countries. Oral health can be integrated with NCD programs and policies to reduce the burden of diseases.