Examining the e-cigarette scenario based on distribution, availability, marketing, and banning: A GIS-Based qualitative study in Bangladesh

by Md Jamil Hossain, Quazi Maksudur Rahman, Md. Abid Bin Siddique, Md Wahiduzzaman, Lakshmi Rani Kundu, Anika Bushra Boitchi, Ayesha Ahmed, Most. Zannatul Ferdous, Afifa Anjum, Md. Munir Mahmud, Md. Maruf Hasan, Tareq Mahmud, Md. Naim Pramanik, Meheruba Khan Sinthia, Tasmin Sayeed Nodi, Md. Mahadi Hassan, Soniya Akter Sony, Noushin Rahman Mahin, Md. Mosaraf Hossain, H. M. Miraz Mahmud, Md. Shakhaoat Hossain, Md. Tajuddin Sikder

Globally, over 81 million people use e-cigarettes, and the majority of them are young adults. Using e-cigarettes causes different types of adverse health effects both in adults and elderly people. Over time, using e-cigarettes has detrimental consequences on lung function, brain development and numerous other illnesses.

This study employed a mixed-methods conducted between June and September 2023, comprising two phases: Geographical Information System (GIS) mapping of available e-cigarette point-of-sale (POS) locations and conducting 15 in-depth interviews (IDIs) with e-cigarette retailers, along with 5 key informant interviews (KIIs) involving tobacco control activists and policy experts. ArcGIS was employed for spatial analysis, creating distribution and type maps, and buffer and multi-buffer ring analyses were conducted to assess proximity to hospitals and academic institutions. Data analysis involved descriptive statistics for GIS mapping and qualitative analysis for interview transcripts, utilizing a priori codebook and thematic analysis.

A total of 276 POS were mapped in the entire Dhaka city. About 55 POS were found within 100m distance from academic institutions in Dhaka city, which offers the easy accessibility of young generations to e-cigarettes. The younger generation is becoming the major target for e-cigarettes because of their alluring flavors, appealing looks, and variation in flavors. Sellers have been using different marketing tactics such as postering, offering discounts and using internet marketing on social media. Moreover, they try to convince the customers by saying that e-cigarettes are ‘not harmful’ or ‘less harmful’. However, retailers were mostly taking e-cigarettes from local wholesalers or distributors. Customers buy these products both from in-store and online services. Due to the absence of laws and regulations on e-cigarettes in Bangladesh, the availability, marketing, and selling of e-cigarettes are increasing alarmingly.

E-cigarette retail shops are mostly surrounded by academic institutions, and it is expanding. Besides, frequent exposure, easy accessibility, and tactful promotion encourage the younger generations to consume e-cigarettes. The government should take necessary control measures on manufacturing, storage, advertising, promotion, sponsorship, marketing, distribution, sale, import, and export in order to safeguard the health and safety of young and future generations.