HAP Journal of Public Health and Clinical Medicine
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Ganesh Vasudevan1, Aarathi Ajayakumar1 and Srikant Ambatipudi1

First Published 22 Dec 2022. https://doi.org/10.1177/jpm.221118619
Article Information Volume 1, Issue 1 January 2023
Corresponding Author:

Ganesh Vasudevan, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapu-ram, Kerala 695011, India.
Email: ganesh.vnvn@gmail.com

1Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-Commercial use, reproduction and distribution of the work without further permission provided the original work is attributed


Background: Tobacco use remains the single largest preventable cause of mortality globally, accounting for 8 million premature deaths each year. Even after a decade of enactment of tobacco control laws in India, their acceptance and successful implementation remain challenging. This study was envisaged to assess the implementation of the Cigarettes and Other Tobacco Products Act (COTPA) in schools and the awareness levels of tobacco control laws among heads, teachers, and students of the schools in Kasaragod district.

Methods: An institution-based cross-sectional survey was conducted to assess the awareness of selected provisions of the COTPA (Sections 4, 5, 6a, 6b, 21, and 25) among the heads of the institutions of 40 randomly selected high schools and higher secondary schools. Similarly, awareness of the COTPA provisions was assessed among teachers (n = 328) and students (n = 402) using self-administered questionnaires. In addition, schools were surveyed for inspecting the implementation level of selected provisions of the COTPA using an observational checklist.

Results: The overall implementation of the COTPA was observed to be 35.5%. The overall self-reported awareness of the COTPA was 13.6%, 25.8%, and 13.1%, among the head of the institutions, teachers, and students, respectively. Government school students had better awareness than that in private schools (42.7% vs 25.2%), although violations of provisions are higher in government schools (OR = 6.0, 95% CI [1.11 to 32.28]).

Conclusion: The overall implementation and awareness of the COTPA provisions was low in the schools of Kasaragod district. The implementation will improve if regular inspection of the schools is done. Increasing the frequency of comprehensive structured training programs for the head of the institution, teachers, and students, and coordinated efforts by stakeholders will help in better implementation of the COTPA.


COTPA, Educational institutes, Kasaragod, Kerala, Tobacco control, Implementation

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