|Year : 2016 | Volume
| Issue : 2 | Page : 107-111
Compliance assessment of cigarette and other tobacco products act in public places of Alwar district of Rajasthan
ML Jain1, Mamta Chauhan2, Rajani Singh3
1 Director, State Institute of Health and Family Welfare, Jaipur, Rajasthan, India
2 Associate Professor, State Institute of Health and Family Welfare, Jaipur, Rajasthan, India
3 Research Officer, State Institute of Health and Family Welfare, Jaipur, Rajasthan, India
|Date of Web Publication||23-Jun-2016|
State Institute of Health and Family Welfare, Jhalana Institutional Area, Jaipur - 302 004, Rajasthan
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: The Government of India has taken various initiatives for tobacco control by enacting comprehensive tobacco control legislation (Cigarette and Other Tobacco Products Act [COTPA], 2003). Objectives: The aim of this study was to assess the level of compliance of Sections 4, 5, 6-a, and 6-b, and 7, 8, and 9 of COTPA with respect to public places, educational institutes, point of sale (PoS), and warning on packaging (COTPA) in public places of Alwar District of Rajasthan. Methods: A cross-sectional observational study was conducted in 2014 in Alwar city and four blocks of the district. The study was done around 365 public places for observing the compliance of Section 4 of COTPA, 357 educational institutions for observing the compliance of Section 6-b of COTPA, and 357 tobacco retailers for observing the compliance of Sections 5 and 6-a of COTPA. Results: The criteria for the evaluation (the core indicators) and decision criteria for a district to qualify for the "Smoke free" status include six parameters. From the total of 365 places visited, 90% places displayed the "No-smoking" signage and out of total 328 places, 99% were as per the COTPA specification. Alwar city, Ramgarh, Thanagaji, and Alwar rural block followed the compliance of Section 4. The PoS visited Alwar district displayed 93% (332) signage and all the displayed signage followed the COTPA compliance. In Alwar city, Thanagaji, Ramgarh, and Alwar rural block, the compliance of Section 6-a was above 90%. The compliance of Section 6-b was above 90% in Alwar city, Ramgarh, Thanagaji, and Alwar rural block. Ninety-three percent (332) of the PoS did not display tobacco advertisement in Alwar district, which is a positive sign of COTPA compliance. Conclusion: This finding suggest a high level of compliance of Section 4, Section 5, Section 6-a, and Section 6-b of COTPA at Alwar district.
Keywords: Cigarette and Other Tobacco Products Act, compliance, signage, smoking, tobacco
|How to cite this article:|
Jain M L, Chauhan M, Singh R. Compliance assessment of cigarette and other tobacco products act in public places of Alwar district of Rajasthan. Indian J Public Health 2016;60:107-11
|How to cite this URL:|
Jain M L, Chauhan M, Singh R. Compliance assessment of cigarette and other tobacco products act in public places of Alwar district of Rajasthan. Indian J Public Health [serial online] 2016 [cited 2019 Dec 6];60:107-11. Available from: http://www.ijph.in/text.asp?2016/60/2/107/184540
| Introduction|| |
Tobacco use is the single most preventable cause of death in the world. Every year, tobacco use kills about 1 million Indians. Bidi and cigarette smokers die 6-10 years earlier than their nonsmoking counterparts.  Tobacco consumption imposes high health-care and productivity costs across India. In 2004, direct health-care costs attributable to tobacco reached 1.2 billion USD, 4.7% of India's total national health-care expenditure. In the same year, approximately, 411 million USD was lost in income due to tobacco-related work absenteeism. 
In the interest of public health, The Ministry of Health and Family Welfare had issued a detailed notification dated May 30, 2008, making rules under the cigarettes and other tobacco products (prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution Act, 2003)  for the prohibition of smoking cigarettes and other tobacco products.
On October 2, 2008, the Indian Government expanded the prohibition on smoking in public places and workplaces to protect individuals from the hazards of second-hand tobacco smoke.
Salient features of the rule
- Restrictions with regard to smoking in public places
- Owner, proprietor, or the manager of all the public places shall ensure that no person smokes in the prohibited area under his/her jurisdiction. It also calls for a signboard to be displayed at the entrance of the premises on each floor including the staircase and the lift
- Detailed provisions have been incorporated for strict implementation of the prohibitory orders
- The manager of the establishment is liable to be fined for any violation by any person of the above prohibition
- The head of the institution/human resource manager/head of administration has to be designated/authorized to prohibit smoking at offices and workplaces
- Ashtray, match boxes, lighters, or other things designed to facilitate smoking should not be provided at the workplace.
It will be necessary for the managers to display in the establishment prominently, the name of the person to whom complaints can be made in case of violation of the provision of these rules.
Implementation of the law is a big challenge for the success of the program. Hence, a study was planned out as a third party assessment for Population Service International (PSI) for finding out the behavior abidance of people in different areas such as public places, government offices, private offices, hospitals, educational institutes, bars and pubs, auditoriums, cinema halls, and public transport facilities in accordance with the Cigarette and Other Tobacco Products Act (COTPA). This study was also meant to find out the level of compliance of the above-mentioned entities with Sections 4, 5, 6, 7, 8, and 9 of COTPA.
Section 4 of COTPA deals with the prohibition of smoking in public places; for the compliance of Section 4 of COTPA, no smoking signage should be displayed at public places and workplaces. These signage should be present at conspicuous places and specification of signage should be as recommended in COTPA with the name of authority displayed and with mobile number to whom violation of the act is to be reported.
Under Section 5 of COTPA, both direct and indirect advertisements of tobacco products are prohibited - absence of retail boards/glow signboards at retail outlets.
Section 6-a is related with prohibition on sale to minors. Sale of tobacco products to and by the persons under the age of 18 is prohibited. The seller (shopkeeper) has to ensure that the person who is buying the tobacco product is not a minor. A specified display board to be put up at the point of sale (PoS) declaring that "sale of tobacco products to minors is prohibited."
Under Section 6-b, the sale of the tobacco products is prohibited within a radius of 100 yards of any educational institution. A display board has to be put up outside the educational institutions declaring the same.
Sections 7, 8, and 9 are concerned with health warnings on tobacco product packs - all tobacco product packages need to carry prominent and legible health warnings. These warnings shall also be pictorial in nature. The warnings will be given in the same language as given on the pack. All imported tobacco products should also carry the specified warnings.
| Materials and Methods|| |
A cross-sectional study was conducted in the public places of Alwar District of Rajasthan during the months of May-June 2014. Out of the 14 blocks of Alwar District, the sample for the study was taken from Alwar city and four blocks. The blocks were selected by 360° approach. Nearly, 25% of the data were covered from the district's headquarter villages and remaining 75% from rural area.
In this study, "public place" was defined according to COTPA 2003 as "places which have public access, whether as of right or not and includes railway waiting rooms, hospital buildings, restaurants, court buildings, public offices, cinema halls, amusement centers, workplaces, shopping malls, libraries, educational institutions, and public conveyances."  The field investigators visited the district headquarters and observed each of the sampled units (public places, educational institutions/PoS) one by one during peak business hours as per the prefixed schedule.
During the study, an unobtrusive observation was made and a structured checklist was filled. The data collected were entered into SPSS 16.0 and analyzed.
| Results|| |
A total of 365 public places were visited during the study, out of which 35 were accommodation facilities, 52 were eateries, 77 were educational institutions, 76 were offices and work places, 55 were health-care facilities, 35 were most frequently visited places, and 35 were public transport facilities in Alwar district [Table 1].
"No-smoking" signage were displayed in 90% (328) of the places, out of which 99% (326) were as per the COTPA. Contact details were written in 76% (251) of these 328 places [Figure 1].
|Figure 1: Compliance of Section 4 of Cigarette and Other Tobacco Products Act – Display of signage as per the Cigarette and Other Tobacco Products Act in Alwar district|
Click here to view
Active smoking was not seen in 94% (343) of the total places visited. Recent smoking was seen only in 8% of the public places and smoking aids were not available at 96% (350) places.
A total of 357 PoSs were visited during the study, out of which 93% (332) were not advertising the tobacco products. The Alwar city and all the three blocks except Kishangarh Bas follow Section 5 [Figure 2].
|Figure 2: Compliance of Section 5 of Cigarette and Other Tobacco Products Act - point of sale not advertising tobacco products in Alwar district|
Click here to view
Among 357 shops evaluated, who were selling tobacco products in Alwar, 93% (332) of the shops displayed the signage which show, "selling of tobacco products below 18 years is an offence" and all the displayed signage follow the COTPA specifications.
None of the vendors were inquired about the age proof.
To check the compliance of Section 6-b, a total of 357 educational institutions were visited, 94% (335) from the total have displayed the signage which shows, "prohibition on sale of tobacco products within 100 yards of educational institutions." All the institutions visited strictly adhere to the compliance by not selling the tobacco products inside the campus. The tobacco products within 100 yards of educational institutions were not sold by 91% (324) of the PoS. Except Kishangarh Bas block, Alwar district, Thanagaji, Ramgarh, and Alwar rural followed 90% of the compliance.
For checking the compliance of Sections 7, 8, and 9 of COTPA, a total of 1245 brands of tobacco products were assessed in Alwar district. Moreover, all the brands including cigarette, bidi, and smokeless tobacco have health warnings on their packaging. This shows 100% compliance of Sections 7, 8, and 9.
| Discussion|| |
Bringing behavioral change, i.e., effective implementation of law which prohibits smoking in public places is not an easier task. The current compliance monitoring survey indicates that the sincere efforts of Alwar administrations along with its partners such as PSI have played a major role in the effective implementation of Sections 4, 5, and 6 of COTPA act, and the stringent enforcement of COTPA by the Government of India and the Government of Rajasthan has led to the implementation of Sections 7, 8, and 9 of COTPA.
The results of this study suggests the effective implementation of the compliance of Section 4 in Alwar city, Thanagaji, Ramgarh, and Alwar rural block as out of the total 365 public places visited, no smoking signage were displayed in 90% (328) of the places, out of which 89% (326) were as per the COTPA. Active smoking was not seen in 94% (343) of the total places visited. The contact details on signage were only mentioned in 69% of the public places. Proper enforcement of law plays a major role in banning smoking in public places, as also clear in a similar study conducted at Mizoram three times, first one in 2009, and then in 2011 and 2013, from which it was seen that tremendous reduction in the amount of public smoking was seen, public smoking dropped drastically from 61.7% in 2009 to 18.2% in 2011 to 7.9% in 2013, with five out of eight districts showing 100% compliance to Section 4 of COTPA (smoke-free rules). Under Section 5: Prohibition of direct or indirect advertisement, promotion and sponsorship of cigarettes and other tobacco products, 94% compliance (120) at Alwar City and 91% (52) at Thanagaji block, 93% (54) at Ramgarh block and 94% (58) at Alwar rural, compliance of Section 5 of COTPA was found. Section 6-a from the 357 PoS visited, 93% (332) PoS displayed the signage which shows, "selling of tobacco products below 18 years is an offence." None of the vendors of all the PoS were enquiring about the age proof. Eight eight percent of The PoS were not selling products to the minors and at 93 % PoS, minors were not selling the products. In a similar observational study cum survey for compliance to COTPA in Mumbai, India, found that minor did not have access of Tobacco products, but nearly, 25% of the tobacco sellers admitted selling tobacco to minor children.  A study from New Delhi and Tamil Nadu states reported 16% and 4% of tobacco vendors, respectively, were observed to be selling tobacco to minors.  For the compliance of Section 6-b, educational institutions are required to display a board at a conspicuous place outside the educational institution premises warning that the sale of cigarettes and other tobacco products in an area within 100 yards of the educational institution is prohibited and is a punishable offense with a fine up to Rs. 200. Ninety-three percent (335) of the educational institutions have displayed warning signage (prohibition on the sale of tobacco products within 100 yards of educational institutions), which is very a good indicator for declaring Alwar as a smoke-free district. As in a similar observational study conducted in the states of New Delhi and Tamil Nadu, only 16% of the total shops/kiosks observed had the specified warning board against the sale to minors and nearly 10% of the shopkeepers were observed selling tobacco products to minors. In 8% of the cases, a minor was observed selling tobacco products.  Worldwide, pictorial health warnings have been proven as an effective strategy to warn tobacco users and nonusers about the harmful effect of tobacco and motivating tobacco users to quit.  In Alwar district, also 100% compliance of Sections 7, 8, and 9 has been observed in the form of pictorial health warnings on all tobacco products.
| Conclusion|| |
Based on the findings of the study, we have concluded that Alwar city and the blocks followed the compliance of Sections 4, 5, 6-a, 6-b, 7, 8, and 9 of COTPA with the following recommendations. For sustaining this compliance of COTPA, the district administration has to keep its efforts in the form of capacity building and periodic trainings for stakeholders responsible for the enforcement of law. Efforts for behavioral change communication in community should also be done simultaneously.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]