Abstract Introduction: Globally, commercial determinants of tobacco play a substantial role in influencing tobacco usage. This context remains underexplored, particularly in remote regions such as western Rajasthan, located in the arid Thar Desert. Therefore, this study was conducted to explore how these commercial factors influence tobacco use in this part of Rajasthan, with the goal of informing policy interventions. Methodology: A cross-sectional study was conducted for stakeholder mapping across the tobacco supply chain and associated influencers in western Rajasthan. We identified and categorized stakeholders along a power–interest (PI) matrix before seeking out the views of policymakers, health professionals, nongovernmental organizations (NGOs), industry, enforcement officers, educators, and consumers via semi-structured interviews. Thematic analysis was conducted to extract key themes among: accessibility, affordability, marketing strategies, regulation loopholes, and public health concerns. Results: Direct and indirect stakeholders were identified through an analysis of the tobacco supply chain. Stakeholder analysis using a PI matrix revealed diverse perspectives and roles influencing tobacco use in western Rajasthan. High-power, high-interest stakeholders such as government health departments and enforcement agencies were actively engaged but faced industry lobbying and enforcement challenges. High-power, low-interest groups such as manufacturers and large traders resisted stronger controls due to economic interests. Low-power, high-interest stakeholders – NGOs, educators, and frontline health workers – were dedicated to awareness and behavior change but limited by cultural norms and misinformation. Small retailers and consumers (low power and low interest) contributed to persistent demand, often unaware of manipulative marketing. Media actors were found to both support cessation and indirectly glamorize tobacco use. Conclusions: The study’s insights highlight an urgent need to address and further study the commercial determinants of tobacco use, contributing to more effective tobacco cessation in western Rajasthan.
Lohra et al. (2026) studied this question.