COVID-19 had a higher impact on the elderly population with 90.2% of deaths arising from people aged above 45.

Our research found that DALYs for males and females were 190 568.1 and 117 310.0 years, respectively, and the YPPLL of the productive population was 28 714.7 and 16 355.4 years. The CPL due to premature mortality was INR3 198 259 615.6 and INR583 397 335.1 for males and females, respectively, while the CPL due to morbidity was INR2 505 568 048.4 and INR763 720 886.1. YPLL for males and females ranged from 189 103.2 to 272 787.5 years and 117 925.5 to 169 712.0 years for lower to higher age limits, and WYPLL was 54 333.9 and 30 942.2 years. The VSL (INR million) for the lower, midpoint, and upper life expectancies was 883 330.8, 882 936.4, and 880 631.3, respectively.

Our study found that vaccination was associated with reduced mortality. The losses incurred due to COVID-19 had a disproportionately higher impact on the elderly and males in West Bengal. Analyzing various age-gender subgroups enhances localized and targeted policymaking to minimize losses in future pandemics.

We also found that knowledge about the ban was high among both the consumers and vendors in Kerala, with 95.7% of consumers and 100% of vendors being aware of it. However, in West Bengal, only 64% of consumers and 62.2% of vendors knew about the ban.

Interestingly, we found that gutkha was still available in 68% of the shops in West Bengal, while in Kerala, no sale of gutkha was reported in shops.

However, half of the vendors we interviewed in Kerala admitted to selling gutkha in the black market.

Overall, we found that the ban had little impact on the sale of gutkha in the open market in West Bengal, while it had a moderate impact in Kerala. However, the black market sales in Kerala are a matter of concern, and we believe that strict legislative measures are essential to cut the supply route for effective implementation of the ban.

This study, published in the Clinical Epidemiology and Global Health, sheds light on the effectiveness of the gutkha ban in two Indian states and highlights the need for more stringent measures to curb the sale and consumption of tobacco products. As responsible citizens, we should all do our part in spreading awareness about the harmful effects of tobacco and advocating for a healthier society.