Publications by authors named "Fikru Tullu"

Background: Positive portrayals of tobacco use in entertainment media can normalize and perpetuate use. In 2012, the Government of India implemented the Tobacco-Free Film and Television Rules, a first-of-its-kind comprehensive regulation to restrict tobacco depiction in films and television programs. Two complementary studies were undertaken to assess the implementation of the film rules on television and in movie theaters.

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Background Dietary salt intake is an important modifiable risk factor for cardiovascular diseases. Estimation of 24-hour salt intake using morning urine samples needs to be validated in the Indian context. We examined the performance of INTERSALT, Tanaka and Kawasaki equations for the estimation of 24-hour urinary sodium from morning fasting urine (MFU) samples.

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Background: Salt substitution (ie, replacement of table and cooking salt with potassium-enriched salt substitutes) is a promising strategy to reduce blood pressure and prevent cardiovascular disease, particularly in countries like India where there is high sodium intake, mainly from discretionary salt, and low potassium intake. Life-threatening hyperkalemia from increased potassium intake is a postulated concern for individuals with chronic kidney disease.

Methods: We used comparative risk assessment models to estimate the number of (1) cardiovascular deaths averted due to blood pressure reductions; (2) potential hyperkalemia-related deaths from increased potassium intake in individuals with advanced chronic kidney disease; and (3) net averted deaths from nationwide salt substitution in India.

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Background: The sale of aerated or sugar-sweetened beverages (ASBs) has been consistently growing in India which has also experienced a major increase in non-communicable diseases. This study estimates the price elasticities of ASBs by different household-income groups in India and examine the trends in their affordability.

Methods: The price elasticity for ASBs were estimated using a nationally representative household sample survey on consumption of ASBs in India and with Deaton's method which is robust to self-reported household expenditure surveys.

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Background: Hypertension is the leading risk factor for cardiovascular disease in India, but less than 10% of the estimated people with hypertension have blood pressure under control. The India Hypertension Control Initiative (IHCI) was implemented to strengthen hypertension management and control in public sector health facilities. Since late March 2020, lockdown due to the COVID-19 pandemic limited healthcare access and disrupted the provision of essential health services.

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India is considered a demographically young country with over 65% of the population aged below 35 years. However, improvements in maternal and child health, and infectious diseases, have created a rapid epidemiological transition with an aging population (8.6% in 2011) with a projected increase (19% by 2050), equating to 104 million.

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Background: Food policies and environment (availability, accessibility, affordability, marketing) in and around educational institutes can influence food choices and behaviours of children and adolescents.

Methods: Cross-sectional, mixed-methods study was implemented in schools (n = 9; Private = 6, Public = 3) and colleges (n = 4) from Delhi and National Capital Region (India). The data was collected from students of schools (n = 253) and colleges (n = 57), parents of school students (n = 190), teachers (n = 12, schools = 9, colleges = 3) and canteen operators of Private schools and colleges (n = 10; schools = 6, and colleges = 4).

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Background: India's tobacco-free film and TV rules were implemented from 2012. To assess the effect of the rules, we studied tobacco depictions in top-grossing Bollywood films released between 2006 and 2017 and rule compliance after 2012.

Methods: Tobacco incidents and brand appearances were coded in 240 top-grossing Bollywood films (2006-2017) using the Breathe California method.

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Article Synopsis
  • The India Hypertension Control Initiative (IHCI) is a collaborative program aimed at controlling hypertension in India, involving 21,895 adult patients from four different states.
  • A significant follow-up assessment revealed that blood pressure (BP) control improved from 26.3% to 59.8% among returning patients, indicating effective management, especially in primary care settings.
  • Despite promising results, the initiative faced challenges with patient retention, highlighting the need for strategies to ensure more patients return for ongoing hypertension care.
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Background: Bidi use remains an intractable public health problem for India. This is partly due to the informal nature of the bidi supply chain, including tax exemptions for small producers. The aim of this paper is to assess the impact of making all bidis subject to duty and Goods and Services Tax.

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Objective: To estimate the magnitude of illicit cigarette consumption in India using a tax-gap approach.

Methods: In the tax-gap analysis, illicit cigarette consumption in India was defined as the difference between total and legal consumption. Data on total cigarette consumption came from two national Global Adult Tobacco Surveys carried out from 2009 to 2010 and from 2016 to 2017.

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The bidi industry in India is predominantly an unorganized sector. It continues to enjoy tax benefits, arguably, to protect bidi workers' interests and employment. Our objective was to study trends in employment and wage differentials in the bidi industry using nationally representative data.

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Introduction: About 28.6% of Indian adults use tobacco. This study estimates the economic burden of deaths and diseases attributable to smoking and smokeless tobacco (SLT) use for persons aged ≥35 years.

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Background: Increasing the price of tobacco through taxation is a very effective means of reducing tobacco use. However, the impact of price increases can be diluted if consumer incomes are growing strongly. The affordability of tobacco products has, therefore, become an important indicator for tobacco control.

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Article Synopsis
  • India implemented tobacco-free rules for films and TV to shield young audiences from tobacco exposure, but compliance with these regulations is lacking on streaming platforms.
  • A study analyzed 188 episodes from 10 popular online series, finding that US productions showed significantly higher tobacco incidents than Indian series, with none of the platforms adhering to Indian regulations.
  • The results highlight a pressing need for stricter enforcement of existing regulations and updates to global guidelines to protect youth from tobacco imagery in the evolving landscape of digital media.
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