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

Abstract

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.

Keywords

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

References
  1. World Health Organisation. WHO Report on the Global Tobacco Epidemic 2008. 2008. https://apps.who.int/iris/bitstream/handle/10665/43818/9789241596282_eng.pdf. Accessed January 30, 2022.
  2. World Health Organization. Tobacco: Key Facts. 2021. https://www.who.int/news-room/fact-sheets/detail/tobacco.Accessed January 30, 2022.
  3.  Anderson CL, Becher H, Winkler V. Tobacco control progress in low and middle income countries in comparison to high income countries. Int J Environ Res Public Health. 2016;13(10):1039. doi:10.3390/ijerph13101039
  4. Singh PK. MPOWER and the framework convention on tobacco control implementation in the South-East Asia region. Indian J Cancer. 2012;49(4):373.
  5. Rai B, Bramhankar M. Tobacco use among Indian states: key findings from the latest demographic health survey 2019-2020. Tob Prev Cessat. 2021;7:19. doi:10.18332/tpc/132466
  6. Siddiqi K, Shah S, Abbas SM, et al. Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries. BMC Med. 2015;13(1):194. doi:10.1186/s12916-015-0424-2
  7. Ministry of Health and Family Welfare, Government of India. Ministry of Health and Family Welfare, Government of India, International Institute for Population Sciences, India Fact Sheet, Key Indicators: National Family Health Survey (NFHS-5) 2019-2020. 2021. http://rchiips.org/nfhs/NFHS-5_FCTS/India.pdf.Accessed January 30, 2022.
  8. Murphy SD. Adoption of Framework Convention on Tobacco Control. Am J Int Law. 2003;97(3):689-691. doi:10.2307/3109859
  9. Jha P, Guindon E, Joseph RA, et al. A rational taxation system of bidis and cigarettes to reduce smoking deaths in India. Econ Polit Wkly. 2011;42:44-51.
  10. The Ministry of Law and Justice. The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003. 2003. 2003. https://www.tobaccocontrollaws.org/files/live/India/India%20-%20COTPA%20-%20national.pdf. Accessed January 30, 2022.
  11. Pradhan A, Oswal K, Padhan A, et al. Cigarettes and Other Tobacco Products Act (COTPA) implementation in education institutions in India: a crosssectional study. Tob Prev Cessat. 2020;6:51. doi:10.18332/tpc/12572
  12. Yadav R, Swasticharan L, Garg R. Compliance of specific provisions of tobacco control law around educational institutions in Delhi, India. Int J Prev Med. 2017;8:62-62. doi:10.4103/ijpvm.IJPVM_239_16
  13. Sharma I, Sarma PS, Thankappan KR. Awareness, attitude and perceived barriers regarding implementation of the cigarettes and other tobacco products act in Assam, India. Indian J Cancer. 2010;47(5):63.
  14. Sharma N, Chavan BS. Compliance to tobacco-free guidelines (Cigarettes and Other Tobacco Products Act) in medical institute of North India. Indian J Soc Psychiatry. 2018;34(3):213.
  15. Ministry of Health and Family Welfare. Operational Guidelines: National Tobacco Control Programme. 2015. Accessed January 30, 2022. https://nhm.gov.in/NTCP/Manuals_Guidelines/Operational_Guidelines-NTCP.pdf
  16. Government of Kerala. COTPA Implementation Review - Kasaragod, DDC Meeting of February 2018. 2018. https://cdn.s3waas.gov.in/s38dd48d6a2e2cad213179a3992c0be53c/uploads/2018/04/2018042821.pdf. Accessed January 30, 2022.
  17.  Prabakaran DP. On the Development of Kasaragod District. Published online 2012:616.
  18. Kamboj M. Bidi tobacco. Br Dent J. 2008;205(12):639-639.
  19. Sunilkumar RKDS. Geographical distribution of cancer in Northern Kerala, India: a retrospective analysis. Alcohol. 2011;317:19.
  20. Jaisoorya T, Beena K, Beena M, et al. Prevalence & correlates of tobacco use among adolescents in Kerala, India. Indian J Med Res. 2016;144(5):704. doi:10.4103/ijmr.IJMR_1873_14
  21. Goel S, Sharma D, Gupta R, Mahajan V. Compliance with smoke-free legislation and smoking behaviour: observational field study from Punjab, India. Tob Control. 2018;27(4): 407-413. doi:10.1136/tobaccocontrol-2016-053559
  22. The Union, Roswell Park Cancer Institute, Bloomberg Initiative to Reduce Tobacco Use, Campaign for Tobacco-Free Kids, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health. Assessing Compliance with Smoke-Free Laws: A “How-to” Guide for Conducting Compliance Studies. May 2014. https://theunion.org/sites/default/files/2020-08/compliance-guide_v4smallerfile.pdf
  23. Kerala Infrastructure and Technology for Education. Kerala Infrastructure and Technology for Education: Prematric Schools List: Kasargod. 2012. http://www.itschool.gov.in/prematricpdf/PDF/Kasargod.pdf. Accessed May 9, 2022.
  24. Jayakrishnan R, Binukumar B, Lekshmi K, Sreekumar, Geetha S. Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala State. Indian J Dent Res. 2011;22(2):195. doi:10.4103/0970-9290.84280
  25. Mini GK, Grace CA, Jinbert L. Complementary and alternative medicine use in the prevention of COVID-19 pandemic: a cross-sectional survey in Kerala, India. Int J Community Med Public Health. 2021;8(11):5329.
  26. Kaur P, Thomas DR, Govindasamy E, Murhekar MV. Monitoring smoke-free laws in restaurants and educational institutions in Chennai, India. Natl Med J India. 2014;27(2) 76-78.
  27. Habbu S, Krishnappa P. Assessment of implementation of COTPA-2003 in Bengaluru city, India: a cross-sectional study. J Indian Assoc Public Health Dent. 2015;13(4):444. doi:10.4103/2231-6027.171165            
  28. Goel S, Kumar R, Lal P, Singh R. How effective is tobacco control enforcement to protect minors: results from subnational surveys across four districts in India. Int J Non-Commun Dis. 2016;1(3):116. doi:10.4103/2468-8827.198583
  29. Sinha DN, Roychowdhury S. Tobacco control practices in 25 schools of West Bengal. Indian J Public Health. 2004;48(3):128.
  30. George RM, Thomas T. Perceptions and practice of tobacco use among adolescents of Mangalore city. J Indian Assoc Public Health Dent. 2018;16(3):242.
  31. Gajalakshmi V, Kanimozhi CV. A survey of 24,000 students aged 13-15 years in India: global youth tobacco survey 2006 and 2009. Tobacco Use Insights. 2010;3. https://doi.org/10.1177/1179173X1000300001
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