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ORIGINAL ARTICLE
Year : 2018  |  Volume : 62  |  Issue : 2  |  Page : 100-103  

Assessment of implementation status of Cigarettes and Other Tobacco Products Act (COTPA) and its awareness among residents in a block of Haryana


1 Senior Resident, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Professor, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication14-Jun-2018

Correspondence Address:
Ramashankar Rath
Room No-14, Ground Floor, Centre for Community Medicine, Old OT Block, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.IJPH_126_17

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   Abstract 


Background: Legislative route is one of the known method to control behaviour of population. Cigarette and Other Tobacco Products Act is one of the laws enacted to control the use of tobacco in India lunched in the year 2003. Objective: The objective of this study was to find compliance of COTPA among tobacco stores and to find the knowledge of people regarding COTPA. Methods: All selected communities were studied by community audit. All stores selling tobacco products were assessed for its compliance to COTPA. Thirty participants from selected communities with in the age range of 18- 65 years were selected and interviewed for knowledge regarding COTPA. Results: A total of 218 stores were found to be selling tobacco. None of the stores were fully compliant to all COTPA clauses. Stores in rural areas were found to be more non-complaint than urban areas. 41% of stores were selling tobacco to minors, 10% were within 100 yards of schools.8% of schools have tobacco advertisement on façade and 24% displayed tobacco products openly. Around half of the participants (n-552) had heard about COTPA whereas only 4% were aware of all 4 provisions of COTPA. Conclusion: Although more than a decade passed since the law was enacted poor compliance and knowledge was found among participants.

Keywords: Cigarette and other tobacco products Act, compliance, India, knowledge, tobacco laws


How to cite this article:
Rath R, Krishnan A, Nongkynrih B, Misra P. Assessment of implementation status of Cigarettes and Other Tobacco Products Act (COTPA) and its awareness among residents in a block of Haryana. Indian J Public Health 2018;62:100-3

How to cite this URL:
Rath R, Krishnan A, Nongkynrih B, Misra P. Assessment of implementation status of Cigarettes and Other Tobacco Products Act (COTPA) and its awareness among residents in a block of Haryana. Indian J Public Health [serial online] 2018 [cited 2019 Nov 20];62:100-3. Available from: http://www.ijph.in/text.asp?2018/62/2/100/234495




   Introduction Top


In 2003, India enacted the “Cigarette and Other Tobacco Products Act,” known as COTPA, but most of its provisions came in 2004.[1] In 2004, India became a signatory to the Framework Convention for Tobacco Control (FCTC), led by the World Health Organization.[2] From 2007 to 2008 onward, the implementation of all tobacco control laws is under the National Tobacco Control Cell under the National Tobacco Control Program. While a legislative route to behavior change has been advocated for many health issues, tobacco has taken a lead in this aspect. However, the real success of this approach depends on how well the law is implemented. While promulgation of a law is a relatively easy and one-time process, the act of implementation is a continuous and more difficult process. This problem is more in tobacco, due to its social acceptability.[3] Implementation of law has two components: first creating awareness about the law and second checking whether the law is being followed or not. Although many studies were conducted to find the compliance of tobacco venders to COTPA, all these studies found poor compliance of tobacco point of sells to section 4, 5, 6 of COTPA.[4],[5],[6] Majority of the studies lack the awareness part. The current status of tobacco control and knowledge regarding COTPA is not known.

Thus, the study was aimed primarily to assess the compliance of the tobacco point of sell to COTPA and secondarily to assess the knowledge of residents of study area aged between 18 and 65 years about the law in villages and urban colonies of Ballabgarh block of Faridabad district in Haryana.


   Materials and Methods Top


This is a community based study conducted in 2013. Study had 2 parts, first part assessed the tobacco stores for their compliance to tobacco laws and the second part consisted of assessment of residents knowledge regarding COTPA and exposure to tobacco promoting advertisements. Assessment was done using a pretested semistructured questionnaire called neighborhood environment assessment tool. This study tool was designed keeping in mind the COTPA and the FCTC regulations. The tool was designed using COTPA clause and subclause and was validated. Content validity was checked by national experts on noncommunicable diseases, and the tool was pretested before use.

Ten villages and ten urban settlements were identified randomly in Ballabgarh block from the 85 villages and 67 urban colonies/settlements with a total population of 188,000. No sample size was calculated as the study was not primarily designed for these objectives. Since no data about the number of tobacco stores were available, community audit was conducted in the selected communities (In rural areas community is defined as villages with its 1k.m. periphery and in urban areas by the urban settlement only), and all streets were visited and retail shops/stores were mapped. Any advertisement either promoting or discouraging tobacco was noted. All retail stores in these communities were included in the study, whether permanent or temporary, and were surveyed to find out whether they were selling tobacco products. These stores were assessed for their compliance to laws using a checklist which included both observation and interview of the shopkeeper. No sampling strategy was used for this part of the study, as all tobacco retail stores in the selected communities were included in the study.

We planned to interview thirty individuals each from these villages/colonies which were selected by modified expanded program of immunization cluster sampling method. From the center of the community, one street was selected randomly, and participants were selected from the first house. Only residents residing in the locality for at least 6 months and aged between 18 and 65 years were included in the study. One eligible participant was taken from each house. If no eligible participant was found, the next closest house was selected. If multiple eligible participants were present in a household, males and younger people were given preference as there was higher chance of missing these populations due to their outdoor activity. They were interviewed to assess their knowledge about the tobacco laws and their exposure to tobacco promotion techniques using an interview schedule. This method was used to capture the variation in knowledge and exposure to tobacco advertisements among different age groups and gender.

Data were entered in Epi-Info-7 (Atlanta, GA, USA) and descriptive analysis was done using STATA-9 (StataCorp, Texas). Differences between rural and urban areas and between genders were tested for significance using the Chi-square test and Fisher's exact test.

The full study protocol was cleared by the Institute Ethics Committee of All India Institute of Medical Sciences, New Delhi.


   Results Top


In the 259 streets assessed from the 20 communities, three streets were found to have tobacco advertisements and only in one community no smoking sign was present. A total of 278 retail stores (all present in the selected communities) were assessed in the rural and urban areas as whole, from which around 218 stores (78.4%) sold tobacco products. Almost 52% of these were selling only smoked tobacco products (cigarette and beedi), 2% were selling only smokeless tobacco products, and 46% were selling both smoked and smokeless tobacco products.

About half (49%) of the 218 stores selling tobacco products displayed tobacco products near the cash counter. Around 9% of stores had tobacco advertisements. One-tenth of tobacco stores was located within 100 m from schools. Around 5% shops employed minors (aged <18 years) in the shops. Around 41% of shopkeepers admitted that they sold tobacco products to minors. No store was found to be fully compliant to the COTPA. The compliance of the stores to different provisions of COTPA Act is shown in [Table 1].
Table 1: Compliance of shops selling tobacco to different provisions of Cigarette and Other Tobacco Products Act (n=218)

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From the planned 600 interviews, we were able to do only 552 interviews. The mean age of the participants was 40.7 years (±13.7). Of the 552 participants interviewed, 102 (18.5%) were current tobacco users. About 45% of the respondents told us that they knew about a law prohibiting smoking at public places. There was no significant difference between the awareness about tobacco laws among male and female participants except banning of sale of tobacco products to minors. Detailed population-level information on the implementation of COTPA is shown in [Table 2].
Table 2: Awareness of tobacco laws and exposure to tobacco promotion techniques

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Only 5% of the respondents were aware of all the four provisions of COTPA. About a quarter (23%) of participants reported that they send their minor children to buy tobacco products and this practice was more in urban areas than rural areas and more among women than men. When asked about exposure to advertisements, about 13% participants reported seeing advertisements of tobacco products in magazines and newspapers and around 5% told that they had seen the same in shops.


   Discussion Top


This study assessed the awareness and compliance to tobacco control laws in selected rural and urban communities. While no shop selling tobacco was fully complaint to tobacco law, the knowledge of the community to all provisions of the law was also poor. This existed in both urban and rural areas as well as in men and women.

In this study, only one shop was found to be displaying signage for prohibition of selling of tobacco products to minors and also health warning was found only in one store. This prevalence was found to be lower than that reported by Pimple et al. and that published by HRIDAY.[4],[7] In this study, “no smoking sign” was found only in one store which was similar to the study by Kumar et al.[8] HRIDAY also reported that in 8% of the stores, a minor was observed selling tobacco products which is similar to 5% seen in this study.[7] The same study also found that 10% of the shopkeepers were selling tobacco products to minors while in our study this was higher (41%).[7]

Only 45% of the study respondents knew that “smoking in public places is banned.” This was similar to that reported by Jayakrishna et al.[9] but less than that reported by Panda et al. (80.8%).[10] Poor knowledge among participants about ban on sale of tobacco products to minors was seen which has also been reported by Jayakrishnan et al.[9] In this study, no significant gender difference in knowledge about tobacco laws was found in contrast to a study by Goel et al.[5]

About 13% participants told that they had seen the advertisement of tobacco products in magazines and newspapers and 5% in shops. This result is very less as compared to that reported by Bansal-Travers et al., which may be due to the difference in the period of study and also the duration of reference.[11] The advantages of the study lie in the fact that this included both community and individual components. It assessed the point of sale and also the residents of the community to assess the consumer side. However, the study was limited by non random selection of participants with in the household which may have provided some bias.


   Conclusion Top


This study clearly shows gap in both implementation of COTPA in tobacco stores and lack of awareness among people. This calls for strengthening of implementation of law by increased awareness generation activities through civil society participation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Annex Three India. Available from: http://www.who.int/fctc/reporting/Annexthreeindia.pdf. [Last accessed on 2015 Jul 13].  Back to cited text no. 1
    
2.
World Health Organization. About the World Health Organization Framework Convention on Tobacco Control. World Health Organization Framework Convention on. Available from: http://www.who.int/fctc/about/en/. [Last accessed on 2014 Aug 31].  Back to cited text no. 2
    
3.
Arora M, Madhu R. Banning smokeless tobacco in India: Policy analysis. Indian J Cancer 2012;49:336-41.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Pimple S, Gunjal S, Mishra GA, Pednekar MS, Majmudar P, Shastri SS, et al. Compliance to gutka ban and other provisions of COTPA in Mumbai. Indian J Cancer 2014;51 Suppl 1:S60-6.  Back to cited text no. 4
    
5.
Goel S, Ravindra K, Singh RJ, Sharma D. Effective smoke-free policies in achieving a high level of compliance with smoke-free law: Experiences from a district of North India. Tob Control 2014;23:291-4.  Back to cited text no. 5
[PUBMED]    
6.
Chaudhry S, Chaudhry S, Chaudhry K. Point of sale tobacco advertisements in India. Indian J Cancer 2007;44:131-6.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Shadow Report Cotpa – FCTC Implementation India; 2010. Available from: http://www.fctc.org/images/stories/FCTC%20implementation%20India%202010.pdf. [Last accessed on 2015 Aug 13].  Back to cited text no. 7
    
8.
Kumar S, Tomar S, Assessing compliance to smoke free legalization in public places of Udupi District, Karnataka: A cross sectional study, IMPACT: IJRANSS, 2014:2;175-8.  Back to cited text no. 8
    
9.
Jayakrishnan R, Geetha S, Binukumar B, Sreekumars, Lekshmi K. Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala state. Indian J Dent Res 2011;22:195-9.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
Panda B, Rout A, Pati S, Chauhan AS, Tripathy A, Shrivastava R, et al. Tobacco control law enforcement and compliance in Odisha, India – Implications for tobacco control policy and practice. Asian Pac J Cancer Prev 2012;13:4631-7.  Back to cited text no. 10
[PUBMED]    
11.
Bansal-Travers M, Fong GT, Quah AC, Sansone G, Pednekar MS, Gupta PC, et al. Awareness of pro-tobacco advertising and promotion and beliefs about tobacco use: Findings from the Tobacco Control Policy (TCP) India Pilot Survey. J Epidemiol Glob Health 2014;4:303-13.  Back to cited text no. 11
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    Tables

  [Table 1], [Table 2]



 

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