{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:33:12Z","timestamp":1755225192328,"version":"3.43.0"},"reference-count":13,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2025,7,26]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Herbal tobacco cessation products (HTCPs), marketed with claims to support tobacco or nicotine cessation, are increasingly sold online in low-income and middle-income countries. However, there is little regulatory oversight or evidence on their safety and effectiveness. This study assessed the availability, affordability, claims and regulation of HTCPs on Indian e-commerce platforms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We systematically searched five major Indian e-commerce platforms (Amazon.in, Flipkart, Blinkit, JioMart and Meesho) using keywords related to herbal tobacco cessation. Product listings were screened and categorised by product type, claimed indications, presence of disclaimers, regulatory approvals and pricing. Findings were summarised descriptively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 316 unique HTCPs across 5 major Indian e-commerce platforms. HTCPs were marketed in three primary formulations: combustible products (42.7%), raw herbal preparations (34.5%) and other formats such as gummies, drops, capsules and patches (22.8%). Products featured diverse flavours (eg, Apple, Paan, Gulkand) and varied widely in pricing (Indian National Rupees (INR)15\u2013INR1467; US$0.18\u2013US$17.67), with premium pricing concentrated on Amazon. Notably, 62.3% of HTCPs carried at least one certification or quality claim, including International Organisation for Standardisation (23.4%), Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (20.3%), Good Manufacturing Practice (15.2%) and Food Safety and Standards Authority of India (13.2%). A small fraction (0.5%) referenced WHO affiliation, raising concerns about potentially misleading endorsements. Additionally, 43.7% of products promoted ancillary health claims such as detoxification or anxiety relief. Only 12% of products displayed age restrictions, and none had functional age verification mechanisms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>HTCPs are widely available on Indian e-commerce platforms with unverified health claims and minimal regulatory disclosure. This poses significant consumer protection and tobacco control challenges. Strengthened oversight, claim verification and policy alignment with WHO Framework Convention on Tobacco Control guidelines are urgently needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tc-2025-059481","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T07:35:29Z","timestamp":1755070529000},"page":"tc-2025-059481","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Herbal tobacco cessation products on Indian e-commerce platforms: an emerging unregulated market with unsubstantiated health claims"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1742-5534","authenticated-orcid":false,"given":"Prashant Kumar","family":"Singh","sequence":"first","affiliation":[{"name":"Division of Preventive Oncology and Population Health, WHO FCTC Knolwedge Hub on Smokeless Tobacco, ICMR - National Institute of Cancer Prevention and Research, Noida, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6039-6164","authenticated-orcid":false,"given":"Vandana","family":"Tamrakar","sequence":"additional","affiliation":[{"name":"Division of Preventive Oncology and Population Health, WHO FCTC Knolwedge Hub on Smokeless Tobacco, ICMR - National Institute of Cancer Prevention and Research, Noida, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-4888","authenticated-orcid":false,"given":"Shivam","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Vital Strategies, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0638-2105","authenticated-orcid":false,"given":"Amit","family":"Yadav","sequence":"additional","affiliation":[{"name":"Vital Strategies, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalini","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Preventive Oncology and Population Health, WHO FCTC Knolwedge Hub on Smokeless Tobacco, ICMR - National Institute of Cancer Prevention and Research, Noida, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"2025081300352148000_tc-2025-059481v1.1","unstructured":"Global Adult Tobacco Survey 2: India 2016-17; Ministry of Health and Family Welfare, Government of India."},{"key":"2025081300352148000_tc-2025-059481v1.2","unstructured":"Ministry of Health and Family Welfare . National tobacco control programme: operational guidelines. 2015."},{"key":"2025081300352148000_tc-2025-059481v1.3","first-page":"S39","article-title":"Tobacco cessation services in India: current status and way forward","volume":"58","author":"Yadav","year":"2021","journal-title":"Indian J Cancer"},{"key":"2025081300352148000_tc-2025-059481v1.4","first-page":"e247","article-title":"Tobacco cessation and the role of primary care in India","volume":"22","author":"Ghosh","year":"2021","journal-title":"Lancet Oncol"},{"key":"2025081300352148000_tc-2025-059481v1.5","first-page":"1","article-title":"Herbal remedies for smoking cessation: fact or fiction","volume":"6","author":"Khanna","year":"2020","journal-title":"Tob Prev Cessat"},{"key":"2025081300352148000_tc-2025-059481v1.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.11166"},{"key":"2025081300352148000_tc-2025-059481v1.7","unstructured":"Government of India . Drugs and magic remedies (objectionable advertisements) act. 1954."},{"key":"2025081300352148000_tc-2025-059481v1.8","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2020-056340"},{"key":"2025081300352148000_tc-2025-059481v1.9","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4103\/ijph.IJPH_707_20","article-title":"Herbal smoke: Next hurricane on horizon","volume":"65","author":"Agnihotri","year":"2021","journal-title":"Indian J Public Health"},{"key":"2025081300352148000_tc-2025-059481v1.10","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1093\/ntr\/ntae142","article-title":"Quitting Smoking With \u2026 Smoke? Unauthorized Claims Used by Herbal Cigarette Manufacturers","volume":"26","author":"Seidenberg","year":"2024","journal-title":"Nicotine Tob Res"},{"key":"2025081300352148000_tc-2025-059481v1.11","doi-asserted-by":"crossref","first-page":"41","DOI":"10.5487\/TR.2015.31.1.041","article-title":"Safety assessment of mainstream smoke of herbal cigarette","volume":"31","author":"Bak","year":"2015","journal-title":"Toxicol Res"},{"key":"2025081300352148000_tc-2025-059481v1.12","doi-asserted-by":"crossref","first-page":"45797","DOI":"10.1021\/acsomega.2c04708","article-title":"How Do Herbal Cigarettes Compare To Tobacco? A Comprehensive Review of Their Sensory Characters, Phytochemicals, and Functional Properties","volume":"7","author":"Abdel Rahman","year":"2022","journal-title":"ACS Omega"},{"key":"2025081300352148000_tc-2025-059481v1.13","doi-asserted-by":"publisher","DOI":"10.4161\/cc.9.11.11842"}],"container-title":["Tobacco Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tc-2025-059481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T07:35:32Z","timestamp":1755070532000},"score":1,"resource":{"primary":{"URL":"https:\/\/tobaccocontrol.bmj.com\/lookup\/doi\/10.1136\/tc-2025-059481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":13,"alternative-id":["10.1136\/tc-2025-059481"],"URL":"https:\/\/doi.org\/10.1136\/tc-2025-059481","relation":{},"ISSN":["0964-4563","1468-3318"],"issn-type":[{"value":"0964-4563","type":"print"},{"value":"1468-3318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]}}}