Should the Ban on Tobacco Sales be Lifted?

RESEARCH REPORT
BACHELOR OF ENGINEERING
IN
CIVIL ENGINEERING
By
Dolay Tshering – 02180010
Sameer Chapagai– 02180035
Sherab Tenzin– 02180041

Under the guidance of

Mr Kelzang Dorji (Guide)
Mrs Chimi Wangmo(Co-Guide)

DEPARTMENT OF CIVIL ENGINEERING AND ARCHITECTURE

COLLEGE OF SCIENCE AND TECHNOLOGY
ROYAL UNIVERSITY OF BHUTAN
PHUNTSHOLING: BHUTAN
2020
Acknowledgement
We would like to express utmost gratitude to our research guide Mr. Kelzang Dorji for his
constant encouragement, excellent guidance, and valuable supervision during the course of the
research work. The guidance and supervision enabled us to learn, execute the required tasks and
complete the research work properly.

We would also like to extend our humble gratitude towards Mrs Chimi Wangmo and Mr Sangay
Passang for their valuable and helpful suggestions during the development and critical
requirements of the research work. Their willingness to be our co-guide and sacrificing her
valuable time generously to help us move ahead in research has been appreciated

We would like to express our appreciation to the College of Science and Technology for their
initiative to include the introduction to research as a module for the third-year students which
gave us the platform to indulge ourselves in productive research and prepare ourselves for the
final year project.

We would like to express our gratitude for the panel members; Mr Karma Tempa, Mr Kirtan
Adhikari and Ms Yeshi Choden during our topic proposal for their kind suggestions which
helped us improve our work.

Special thanks to the all the people who helped us by filling the up the questionnaires without
which our research work would have been incomplete.

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Abstract
The purpose of this paper is to study the effectiveness of the policy on tobacco sales and the
impacts of tobacco sales in Bhutan and ultimately determine whether the ban on tobacco sales
should be lifted or not. There is a need for dissemination of awareness of the effects of tobacco
and this study helps to provide an overview and knowledge for implementing the ban on tobacco
sales. A self-administered questionnaire was used to collect the data. Descriptive and graphical
analysis tool were used to interpret the data in tables and graphs. The sample group included
representative individuals of age group 15 to 60 years.

These study results re- emphasize the effectiveness of the policy on the tobacco ban especially
after the passing of the Tobacco Control Act of Bhutan. The results also provide information
regarding the impacts of tobacco sales on Health, Economy and Religion and Society. The
findings may help the policy makers and the government to understand the merits and demerits
of tobacco sales which they may use to decide whether the ban on tobacco sales should be lifted
or not.

1.2 Key words

Tobacco sales, tobacco ban, impacts of tobacco, Bhutan, Finance, Bhutan Duty Free Limited
(BDFL), religion, society, health.

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Introduction
Tobacco use is a rampant practice all over the world (WHO, 2018). In the last two decades the
overall tobacco users has reduced from 1.375 billion in 2000 to 1.337 billion in 2018 according
to the WHO global report on trends in prevalence of tobacco use 2000-2025 third edition. The
big ban on the tobacco sales in Bhutan was officially announced in 2004. The news on the ban of
tobacco sales attracted the attention of many international media and was seen as a bold move
(The Big Ban, 2018, p. 15). The main reason for the ban as noted in the official record for the
70th National Assembly Session was that tobacco is injurious to health and is not in conformity
with the Buddhist beliefs (National Assembly of Bhutan, 1991).

Bhutan has implemented the ban on tobacco products since 2004 and with the passing of the
tobacco control act of Bhutan 2010, the ban was further strengthened. It provides a
comprehensive legal framework for the implementation of tobacco control policies and prohibits
cultivation, manufacture, distribution, and sale of tobacco products (both smoked and smokeless
forms) within Bhutan (Tobacco Control Act of Bhutan, 2010). However, the law does not ban
the consumption of tobacco and people can import a controlled amount of tobacco products by
paying 100 % sales taxes.

As of today, Bhutan still stands as the only country in the world to implement a nationwide ban
on tobacco sales (Parameswaran, 2012). The ban remained ineffective until the passing of the
Tobacco Control Act in 2010 by the government. Anybody in illegal possession of tobacco could
be charged with a minimum imprisonment of three years. However, tobacco users can import
controlled amounts of tobacco products after paying 100 percent sales tax on all tobacco
products entering the country (Tobacco Control Act of Bhutan, 2010). This resulted in the
emergence of black markets dealing with tobacco sales (Caruana, 2017). Shops that are involved
in the black market thrive on illicit sale of tobacco and its products, and have found a way
around the law. This has culminated in a never-ending supply of loyal customers which continue
to sustain these shops growing into a network of black market (The Big Ban, 2018, p. 15).

The Global Youth Tobacco Survey (GYTS) of Bhutan 2013 reported an increase in the
prevalence of tobacco use, from 18.8% in 2006 to 30.3% in 2013 (GYTS, 2014). Even with the
ban on tobacco sales, there has been an increase in the use of tobacco which hints at the
ineffectiveness of the policy on the ban of tobacco. The unimproved tobacco consumption trend
in Bhutan and the rampant smuggling of tobacco products also calls for a change in the policy
and the anti-tobacco program (Givel, 2011). There is a substantial loss of tax money due to the
growing number of tobacco black markets. There are several research papers and studies done
on tobacco ban. However, there are not many studies done on the impacts (positive and negative)
of tobacco sales on Economy, Health and Religion and Society and the effectiveness of the
policy on tobacco ban. The information on the possible consequences seen from tobacco sales is
lacking. The temporary lifting of the ban on Tobacco sales by the government (Wangdi &
Gyeltshen, 2020) due to the pandemic was a cause for us to reevaluate tobacco sales.
1
This study is aimed at finding out the impacts (positive and negative) of tobacco sales and the
effectiveness of the policy on tobacco ban. The study will also help to understand about a
scenario where tobacco sales are legal. This can help to bring a clear justification on the decision
made to ban tobacco sales in the country. Only through knowing the impacts tobacco sales would
have, can we ask questions such as ‘Should tobacco sales be banned or allowed?’, ‘Does it bring
more harm or benefits to the people?’ and ‘Should people support tobacco sales or keep the ban
un-lifted. The significance of this study is to reevaluate the tobacco sales in the country and view
the matter from all possible sides. Ultimately a conclusion is made to determine whether the ban
on the tobacco sales in the country should be lifted or not.

Methods
3.2 Study Design and Participants
A self-administered questionnaire was distributed to all the representative individuals of age
group 15 to 60 years including both tobacco users and non-users by means of Google forms. The
minimum sample required was 100.

The research instrument was a self-administered questionnaire on the following variables:

Gender, Age group, tobacco users, different brands of tobacco products used, religion’s stand on
tobacco and the amount of tobacco consumption. Those who used tobacco products in the last 30
days were considered as tobacco users. A pre-test was conducted with 20 people consisting of
individuals from age group 15 to 60 years. The actual survey conducted had 135 respondents
from places concentrated mostly in Chukha, Thimphu and Paro.

3.3 Data Collection

Data collection include archive retrieval from various government agencies such a such as
Statistical Yearbook from Royal Bhutan Police, Prices of tobacco products from Bhutan Duty
Free Limited, Ministry of Finance, Ministry of Health, Custom and revenue of Bhutan, Fact
Sheet 2018 Bhutan, WHO, National ll Health Survey 2012, Bhutan Trade Statistics, Global
Youth Tobacco Survey of Bhutan2019. The questionnaire was disseminated through online
platforms such as E-mails, Facebook, Wechat, and Messenger. The anonymity and
confidentiality of the respondents were maintained and the data generated through the online
form was collected for analysis.

The study uses Evaluation method of research which is intended to produce a real- world impact.
This was also a cross sectional descriptive study. Also incorporated in this analysis will be an
examination of WHO report on the global tobacco epidemic, 2019 on Country Profile Maldives,
Notification by Department of Revenue & Customs, Ministry of Finance banning sales of
tobacco products, a 2005 Notification by the Ministry of Trade and Industry banning smoking in
public places, and Tobacco Control Act of Bhutan 2010.

2
3.4 Data Analysis
The effectiveness of the policy on tobacco and the impacts of tobacco sales analysis associated
with this study is a qualitative, descriptive statistical and archival content overview of various
materials from reliable sources.

MS Excel was used for data analysis. Descriptive and graphical analysis was used to limit the
generalization to groups of individuals observed. It lets us first estimate then summarize the data
graphs and tables to meet the objectives. This also describes the demographic characteristics and
tobacco use behavior of the participants, the effectiveness of the policy and the impacts of
tobacco sales on Health, Economy and Religion and Society.

Results and Discussion

5.1 Demographic Information
Total 135 people took part in study conducted. Of them, 51 were female (38.1 percent) and 83
males (61.9 percent). Maximum of the respondents (81.1 percent) followed Buddhism followed
by Hinduism (11.4 percent) and few are Christians and atheist. The response received are from
all the Dzongkhags of the country with majority from Chukha (28 percent) followed by
Thimphu(19.7percent) and Paro (12.9 percent). Tobacco users among the respondents are 42.5
percent and 72.7percent of the tobacco users have tried to quit tobacco consumption in the past.

5.2. Impacts of Tobacco Sales on Finance

5.1.1 Impact of tobacco sales on the finance on the country
According to the Tobacco Control Act of Bhutan 2014, buying and selling of tobacco products
inside the country is prohibited but a person can import tobacco and tobacco products for
personal consumption as per the quantity approved by the Tobacco Control Board after paying
taxes. After getting the response from the questionnaire, it was found that 86 percent of the
respondents who consumed tobacco products purchased their tobacco product from the local
shops indicating they don’t pay tax to the government.

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Figure 1 Pie chart showing the mode of buying

Tobacco Import Declared in Ngultrum

2,092,720

1,678,996 1,738,640
Amount(Nu)

1,069,083
844,156
658,362

2015 2016 2017 2018 2019 2020(Till June)

Year

Figure 2 Bar graph showing the import of tobacco

Source: Trade Statistics of Bhutan, Ministry of Finance (2015 to 2020).

From the graph in figure 2, there is significant decrease in the amount of tobacco declared in
2018 and 2019 compared to previous years and there is sudden rise in 2020 till June. The drop in
2018 and 2019 and sudden increase in 2020 indicates the prevalence of black market and
individuals importing the tobacco products without paying taxes. In 2020 when international
borders were sealed, Bhutan Duty Free Limited (BDFL) started importing and supplying the
citizens with tobacco products so citizens started buying the products from BDFL which declares
the imported tobacco product therefore there is sudden rise in the declared import of tobacco.
Comparing the Amount of Tobacco Declared in 2019 and 2020(till June) there is increase in
declared tobacco import by more than 3 times in mere 6 months so it can be assumed that high

4
amount of tobacco has been imported in 2019 and 2018 in the country without paying taxes
affecting the revenue generation of the country.

In 8 November 2020, police and the officials at Allay Land Customs Station seized tobacco
products worth 2.7 million. After closing of gates on March 23, Phuntsholing has arrested 47
people attempting to smuggle tobacco and other controlled substances. (Rajesh Rai, 2020). Even
during pandemic people are putting their lives at risk and trying to smuggle tobacco products so
it can be well understood how rampant the illegal import of tobacco was prevalent in the country
pre-pandemic.

Maldives is a small island nation in South Asia which has population of 515,696(in 2018).
Maldives resembles Bhutan both in population as well as the geographic size. Therefore, making
comparison between the two nations is feasible. According to the WHO report on the global
tobacco epidemic, 2019, Maldives generated 37369727$ by imposing 69% sales tax on the
tobacco products. So, should the ban on tobacco sales be lifted, the government of Bhutan can
impose a certain percent as sales tax which can be a source revenue generation or the country.
Currently Bhutan only imposes 100% tax for self-consumption and not on sales on tobacco sales.

5.1.2 Impact of ban of tobacco sales on the finances of Tobacco Consumers

According the data acquired from the questionnaires circulated, it was found out that the most
common tobacco products consumed are Baba (chewing tobacco), Flakes Cigarettes and Will
Navy Cut (Cigarettes).

Before the Corona Pandemic occurred and the border gates were open the prices of the tobacco
products mentioned above is given in the Table 1.

Product Name Prices in Indian Prices in Local Shops Price after paying the
Bordering Places taxes.

Baba Nu.50 per bundle Nu.150 to Nu200 per Nu.100 per bundle
bundle

Flakes Nu.50 per packet Nu.100 to Nu 150 per Nu.100 per packet
packet

Wills Navy Cut Nu.100 per packet Nu.150 to Nu 200 per Nu. 200 per packet
packet
Table 1 Prices of tobacco products pre-pandemic

During the Corona Pandemic and the border gates are close the prices of the tobacco products
mentioned above is given in the Table 2.

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 Product Name Prices in Local Shop Prices in Bhutan Duty Free
Limited

Baba Nu.60 to Nu 200 per packet Nu. 15 per packet

Flakes Nu 150 to 200 per packet Nu.150 per packet

Wills Navy Cut Nu 250 to Nu 350 per packet Nu.180 per packet
Table 2 Prices of tobacco products during pandemic

From the data acquired from the questionnaire, it is found that the maximum number (86% of the
tobacco products consumer respondents) of the tobacco consumers bought the tobacco products
from the local shops. Even though the prices in local shops are higher than the price of the
products after the paying the taxes, the tobacco consumer in the Bhutan prefer buying the
products from the local shops.

During the pandemic time, the shopkeepers have started to milk the situation. Taking advantage
of the addiction of the tobacco products, shopkeepers have hiked the price of the tobacco
products especially for Baba by more than 75 percent. Even though the Bhutan Duty Free
Limited has started to supply tobacco products but it has not been able to provide it to all
individual. Moreover, the consumers must stay in queue and there is a limit to the amount of the
product an individual can purchase.

5.2 Impacts of Tobacco Sales on Health

5.2.1 Harmfulness of tobacco on health
From the survey conducted the severity of health issues relating to tobacco consumption is a
known by 94% of the respondents while 5.2 % remains ignorant as shown in Figure 3. Although
every citizen is aware of the negative impacts of tobacco on our health people use it.

5.2.2 Death cases

According to research done in 2018 (FACTSHEET BHUTAN, 2018), more than 120000 people
out of total population are current tobacco users and a substantial number of people exposed to
second-hand smoking. Along this they found that tobacco kills 221 people each year that are
5.7% of all deaths.

Out of 221 deaths related to tobacco each year it was found that 42% was caused by
cardiovascular diseases (CVDs), 14% by Cancers, 25% by chronic respiratory diseases along
with 13% by Communicable, maternal, neonatal and nutritional diseases and 6% by other
diseases.

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Figure 3 Pie chart on the awareness of the effect of tobacco on health

5.2.3 Second-hand users

People often think the only people harmed by tobacco use are long time users. The fact is that
tobacco use can be harmful not only the users but everyone in society. Everyone in society be it
family member or neighbour or stranger is affected by second-hand smoke from tobacco users.

Tobacco smoke has more than 7,000 harmful chemical compounds that enter a human body
either directly through smoking, indirectly through second-hand exposure to smoke exhaled by a
smoker or through downstream smoke released from a cigarette or pipe.

Breathing in second-hand smoke can cause diseases that slowly lead to death and death before
birth. Most common causes of inhaling second-hand smoke are:

 Asthma
 Respiratory infections
 Lung problems
 Ear infections
 Sudden infant death syndrome (SIDS)
 Higher blood pressure
Even under the same roof the relationship between tobacco user and non-user will become
farther and thinner. It brings disharmony in the house.

5.3 Impacts of Tobacco Sales on Religion and Society

Studies have found that higher religiosity is associated with a lower rate of tobacco, especially
among youth. In fact, a recent review of the literature concluded that greater religious
involvement was associated with a lower risk of tobacco use (Garrusi B & Nakhaee N,2012).

7
From the study conducted, it was found that 79.7% agreed that tobacco is bad according to their
religious beliefs. According to the meeting on Tobacco and Religion carried out by WHO in
1999, following conclusions were derived:

 Buddhism teaches the path of freedom. Freedom implies a way of life without
dependence on anything, a life of mental clarity. This clarity comes from being free of
addiction. It is of prime importance to do the utmost to take care of the body and mind,
both one’s one own and those of others.
 Tobacco is traditionally seen in Hindu teaching as a vyasana, that is a dependence
unnecessary for the preservation of health. The vyasana impedes attainment of the Hindu
goal of spiritual life: cessation of suffering, access to bliss which is not a limited joy, and
freedom from the bondage of nature.
 According to Christianity harming one’s own body is considered sin. Since tobacco
consumption has adverse health impacts, Christianity prohibits the use of tobacco.

Abundance of tobacco products because of lifting the ban on tobacco sales can potentially lead to
a rise in tobacco users especially among the age group below 25 years. Through the self-
administered questionnaire, ‘Curiosity’ as the reason for starting tobacco consumption was found
to be 62.3%. Curiosity as defined by Lombroso is a desire for information by experimentation. A
curious youth engulfed in the desire to seek information by experimenting using tobacco but is
hesitant in the beginning due to its illegality will no longer hesitate to consume tobacco should
the ban on tobacco be lifted. This hesitation also known as social inhibition acts as a limiting
factor and restricts to a consensual number of trials (Wikipedia). As a consequence of absence of
an initial inner inhibition, a rapid increase in the tobacco users can be expected due to the
availability of tobacco products.

Figure 4 Pie chart showing personal reasons for starting tobacco consumption

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In the article ‘What impacts does the environment have on us’, it states that society and
environment are interlinked with each other, can influence peoples' behavior and motivation to
act and influence the mood. Cigarette butts, plastic filters and other remnants of smoked
cigarettes can pollute soil, beaches and waterways. Studies have also shown that cigarette waste
is harmful to wildlife and releases enough toxins to kill 50 percent of the saltwater and
freshwater fish exposed to it for 96 hours (Tobacco and Environment, 2018).

Some people smoke when hanging out with friends or to feel comfortable in social situations.
Social smokers smoke occasionally and almost always in groups. This is termed as Social
Smoking (Social Smoking). Should the tobacco sales be allowed, there would be a hike in the
social smoking activities. As described in the article ‘Social Smoking’, like regular smokers,
social smokers have the smell of smoke on their clothes and on their breath. Plus, social smoking
means the people you’re with are exposed to secondhand smoke. Secondhand smoke is
dangerous to anyone who breathes it in. This culminates in health hazardous scenarios where the
smoke contains high levels of carbon monoxide, metals, and chemicals known to cause cancer.
From the self-administered questionnaire circulated among 135 responses, 80% believe that
tobacco causes social disharmony in respect to health hazard towards the smokers and second-
hand smokers.

Figure 5 Bar graph showing the reasons for starting tobacco consumption in general

Through the questionnaire it was found that 86.6% of the respondents have agreed to have the
knowledge on the ban of tobacco sales in Bhutan. Contradictorily, the consumption and sales of
tobacco products have been rampant as ever.  Still, more than 560 children (10-14 years old) and
36130 adults (15+ years old) continue to use tobacco each day (Issues, 2013). This infers at the
negligence of majority of the people towards the ban of tobacco sales in Bhutan.

5.4 Effectiveness of the Policy on Tobacco Sales

After the analysis of archival data on the impacts of tobacco sales on Finance, health and survey
responses, the following inferences are made:

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 1. After the implementation of the Tobacco Control act of Bhutan 2010, there has been
rampant prevalence of illegal smuggling of tobacco products and black market in the
country affecting both the revenue generation and imposing financial burden on the
tobacco consumers.
2. And there has been observed a rapid hike in the number of tobacco users after the passing
of the Tobacco Control Act of Bhutan 2010 (Big Ban, 2018).
3. After the implementation of the Tobacco Control act of Bhutan 2010, tobacco related
issues came into the limelight spreading awareness of the effects of tobacco products.

Despite efforts to ban tobacco sales and restrict smoking in public places, tobacco consumption
and exposure to secondhand tobacco smoke, so far, remain a significant problem in Bhutan
(Givel, 2011). In addition, illegal tobacco smuggling and a robust black market are also a serious
problem.

Conclusion
This is a research to find out whether the ban on tobacco sales in Bhutan should be lifted. This is
achieved by determining the impacts of tobacco sales on finance and economy, health, religion
and society. Should the tobacco sales be allowed, there is a potential to generate high revenue
through the acquisition of taxes imposed on legal tobacco sales. Tobacco has been found to have
more negative impacts on health. Studies have found that higher religiosity is associated with a
lower rate of tobacco and cause disharmony in the society.

The significances of this study are that it helps to accept the prompt decision by the government
to temporarily lift the ban on tobacco sales due to Covis-19 pandemic has become a reason for
many people to become apprehensive. The idea of lifting the ban can also be prone to misleading
which could potentially cause misinformation and create detrimental gap in context to tobacco
on finance and economy, health, religion and society. Since this study also focuses on the
effectiveness of the policies on tobacco sales, this research can act as a base on which future
aspiring researchers can study the policies on other related substances such as alcohol and
marijuana.

Ban on the tobacco sales should not be lifted under the condition that only Bhutan Duty Free
Limited should continue to supply the tobacco products. This will help to curb the prevalence of
black market and prevent illegal smuggling of tobacco. In addition, it can also prevent minors
from abusing tobacco products as BDFL can monitor and prevent selling to minors. If tobacco
consumption trends do not improve and smuggling is not successfully counter-acted, Bhutan
should consider changing, to some degree or in total, its anti-tobacco program. After conducting
the research, the following recommendations can be implemented to addresses the issue of rising
the tobacco usage and the prevalence of black market and illegal import of tobacco products.
Small outlets of Bhutan Duty Free limited should be made available from place to place so the

10
tobacco consumers do not have to depend on the local shops. Moreover, BDFL can monitor the
age limit of the buyers thus preventing minors from abusing tobacco. Also, the shopkeepers
would not be able to overcharge the customers. Or another alternative to the former is to license
certain number of shops to sell tobacco products imposing certain sales tax. And lastly,
awareness program regarding Tobacco Control Act of the Bhutan should be conducted.

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BHUTAN TRADE STATISTICS MINISTRY OF FINANCE. (2018).

BHUTAN TRADE STATISTICS MINISTRY OF FINANCE. (2019).

BHUTAN TRADE STATISTICS MINISTRY OF FINANCE. (2020).

Choden, P. (2007). Tobacco Legislation at Hand. Kuensel Online.

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E. V. (2010). EVS 2008 Master Questionnaire. https://doi.org/10.4232/1.10059

Givel, M., & Givel, M. (2016). Tobacco Policymaking and Administration in Bhutan from 1991
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Gurung, M. S., Pelzom, D., Dorji, T., Drukpa, W., & Wangdi, C. (2016). Current tobacco use
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Appendix

9.1 Appendix A: Survey Questionnaire.

1. Gender
a. Male
b. Female
c. others
2. Which age group do you fall under?
a. 15-25
b. 26-60
3. Ethnicity
a. Buddhist
b. Hindu
c. Christian
d. Others
4. Occupation
a. Students
b. Governmental Jobs
c. Private business
d. Unemployed
e. House wife/ house husband
f. Others
5. Give your current location
6. Are you aware of the ban on Tobacco sales and tobacco products in the Country?
a. Yes b. No
7. Are you familiar with ‘The Tobacco Control Act of Bhutan’?
a. Yes
b. No
c. maybe
8. Do you think Tobacco causes disharmony in the society?
a. Yes
b. No
c. Maybe
9. If so, how does tobacco cause disharmony in the society?
a. Tobacco is hazardous to the health of both users and non-users
b. Marital discords (one spouse does not like the other spouse using tobacco)
c. Financial burden
d. Stigmatization against tobacco users
e. Others

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 10. Rate the availability of tobacco products in your society from 1 to 10 ( 0 being the least and 5
being the most abundant)
a. 1
b. 2
c. 3
d. 4
e. 5
11. What is your religion’s stand on Tobacco?
a. Tobacco is good
b. Tobacco is bad
12. Do you believe in your religion’s stand on Tobacco?
a. Yes
b. No
13. Are you aware of the effects of tobacco on Health?
a. Yes
b. No
c. Maybe
14. What do you think are the reasons people consume tobacco?
a. To relieve stress
b. For pleasure
c. Because of social situations
d. others
15. Have you smoked Tobacco in the past?
a. Yes
b. No ( Submit Response)
16. Have you used Tobacco products in the last 30 days?
a. Yes
b. No
17. What types of Tobacco products do you use?
a. Smokes (cigarette, bedi)
b. Non-smokes (Bundles, Baba)
c. Both
18. How often does anyone in your house smoke?
a. Daily
b. Weekly
c. Monthly
d. Less than monthly

19. What is your weekly tobacco consumption?

a. 1-5 packages
b. 5-10 packages
c. More than 10 packages

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 20. What brand of tobacco products do you use?
a. Flakes
b. Wills
c. Baba (bundles)
d. Bedi
e. Cigar
f. Others
21. How much does it cost to buy any of the following?
a. Flakes:
b. Wills:
c. Baba:
d. Bedi:
e. Cigar:
22. Reason for starting tobacco consumption
a. Peer pressure
b. Curiosity
c. Family problems
d. Others
23. During the last 12 months, have you tired quitting tobacco?
a. Yes
b. No

Appendix B: Gender wise data analysis.

  Gender
Questions No.   Male Female
Gender   61.90% 38.10%
Above 25 29.40% 26.13%
Age Group Below 25 70.60% 73.87%
Are you aware of the ban on Tobacco sales Yes 62.22% 62.21%
and tobacco prodcts in the country? No 37.78% 37.79%
Yes 46.67% 61.12%
Are you familiar with No 14.36% 15.55%
'The tobacco Control Act of Bhutan'? Maybe 38.97% 23.33%
Yes 83.77% 93.92%
No 2.39% 3.89%
Are yoi aware of the effects of tobacco on health? Maybe 13.84% 2.19%
Yes 50.94% 33.90%
. Have you used Tobacco products in the last 30 days? No 49.06% 66.10%
Table 3 Gender wise data analysis

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