Urgent Need to Regulate Herbal and Nicotine-Based Tobacco Products in India

Abstract

India’s evolving tobacco product landscape presents emerging regulatory and public health challenges, particularly with the growing popularity of herbal and nicotine-based alternatives such as herbal cigarettes, nicotine pouches, heated tobacco products (HTPs), and electronic nicotine delivery systems (ENDS). Despite regulatory frameworks including COTPA, NTCP, and the Prohibition of Electronic Cigarettes Act (PECA), public misconceptions regarding the safety of these products persist. To assess awareness and perceptions, a two-phase study was conducted in January–February 2025. The first phase involved a cross-sectional online survey (n=90) using a pre-validated questionnaire examining knowledge, attitudes, practices, and exposure. The second phase included a national webinar with multidisciplinary stakeholders to explore regulatory and enforcement concerns.

Findings revealed that 34.5% of participants perceived herbal products as less harmful than conventional tobacco, while 17.2% were uncertain. Although 84.5% were aware of newer nicotine-based products, gaps in accurate risk perception remained. A majority supported stricter regulation, mandatory ingredient disclosure, banning misleading health claims, and integrating these products into national tobacco control campaigns. Persistent accessibility of banned products and concerns regarding youth appeal were also highlighted. These findings underscore the urgent need for strengthened regulatory enforcement, public education, and multisectoral policy action to prevent emerging nicotine products from undermining tobacco control progress in India.