Background and Context:High prevalence of tobacco use in India is a challenge to health and wellbeing of its citizens. The habit contributes to rising deaths due to cancer. About USD 300 million is lost due to tobacco-related cancers in India with 38% of this burden shared by women. The FCTC recommends evidence based measures, also reflected in India’s tobacco control law (COTPA). However, effective implementation is a roadblock. The project, ‘Strengthening of Tobacco control Efforts through innovative Partnerships and Strategies’ (STEPS) envisioned strengthening implementation of evidence based tobacco control (TC) measures in two Indian states of Andhra Pradesh and Gujarat.
Aim:To generate research evidence supporting TC policies and build capacity of law enforcers, media, NGOs and other stakeholders ensuring compliance with FCTC and COTPA for strengthening the National Tobacco Control Programme.
Strategy/Tactics:Observational research was undertaken in intervention districts to monitor compliance with smokefree-law, prohibition on sale of tobacco products to and by minors and within 100 yards of educational institutions and pictorial health warnings on all tobacco products. Key stakeholders at the state, district and sub-district levels were sensitized to TC policies. Parallel efforts were made to build capacity of implementers. Media and NGOs were engaged to actively demand and monitor compliance.
Programme/Policy Process:Overall, 24 District Tobacco Control Advisory Committee meetings and 51 sub-district level Community against Tobacco (CAT) group meetings held. Over 1500 law enforcers trained and 34 senior journalists sensitized. Sensitization of kiosk owners resulted in significant reduction in tobacco vending within 100 yards of schools. Monitoring by youth volunteers resulted in significant increase in compliance with smokefree-laws by restaurants.
Outcomes/What was learned:Enforcement strategies supported by research, media engagement, community-level advocacy and sustained capacity building efforts ensure effective implementation of TC laws. Along with administrative will, building community-level implementation and monitoring bodies are critical to compliance.