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Some ministries cooperate well, but others show limited engagement. (I5) This low prioritization is further compounded by frequent personnel turnover, which disrupts continuity and weakens coordination: Representatives rotate frequently, so its not the same person consistently participating, resulting in discontinuity in operations. (I9) Organizational and role clarity deficiencies of secretariat for the SC-NTCS The Bureau of Tobacco Control appointed division heads as secretaries for each NTCS strategy, assigning them responsibilities such as preparing agendas, monitoring progress, and reporting issues to chairpersons

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A pilot study on oral microbiome in electronic cigarettes consumers versus traditional cigarettes smokers