Online Program

Accessibility of tobacco by youth in India: An observational study of compliance with the cigarettes and other tobacco products act (COTPA)

Tuesday, November 5, 2013

Erin Mead, MHS, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Rajiv N. Rimal, PhD, Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, DC
Joanna Cohen, PhD, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Ellen Feighery, RN, MS, Public Health Institute, Oakland, CA
Nilesh Chatterjee, PhD, MA, MBBS, Bloomberg School of Public Health, JHUCCP (Johns Hopkins University Center for Communication Programs), New Delhi, India
Background: COTPA prohibits the sale of tobacco products by youth (<18) and within 100 yards of schools, requires specific signage stating these restrictions at vendors and schools, and requires vendors not to display tobacco products within easy access to youth. We examined the extent of compliance with these provisions and factors associated with compliance. Methods: In 26 urban and rural towns in five Indian states (Bihar, Karnataka, Kerala, Maharashtra, Rajasthan), we assessed compliance among 505 vendors and 298 schools. Multilevel logistic regression models were used to identify factors associated with compliance, adjusting for a city-level random intercept and state-level robust variance estimate. Results: Only five (1%) of the vendors were fully compliant with the provisions banning sales by youth, restricting the accessibility of tobacco products by youth, and requiring the correct signage. Forty percent were moderately or highly compliant (with ≥2 provisions). The odds of vendor compliance did not change as a function of town size (P=0.85) or vendor type (P=0.31). Vendors sold tobacco within 100 yards of 67% of the schools. Only 6% of schools displayed required signage, none of which were in rural towns. The odds of compliance with the ban on sales near schools was 96% lower in moderately sized cities than rural towns (P<0.001) and 92% higher in secondary than primary schools. Conclusion: Compliance with COTPA provisions regarding the sale and display of tobacco products is low in these five states in India. Greater enforcement is needed to reduce the accessibility of tobacco products by youth.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Identify key challenges in the implementation of tobacco control policies to limit accessibility by youth in India Compare similarities and differences in compliance rates by city population size and type of vendor/school.

Keyword(s): Youth Access, Tobacco Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a PhD student in social and behavioral sciences and have worked on multiple research studies about the social and behavioral risk factors for cancer, including tobacco.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.