Compliance Assessment of Cigarette and Other Tobacco Products Act in Public Places in Delhi Government Hospitals

Document Type : Research Articles


Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, Delhi, India.


Objective: Tobacco-free policies in hospital campus reduce exposure to tobacco smoke; change the demeanour of
the professionals, patients and people visiting hospitals towards tobacco use. Section-4, 5 and 6 of COTPA (Cigarettes
and Other Tobacco Products Act) necessitates the need for implementation of the prohibition on smoking in public
places. Against this background, the present work was designed to evaluate the status of compliance Section 4, 5 and
6 of COTPA in Delhi Government hospitals Methods: A cross-sectional observational study was conducted within
Government hospitals. Multistage random sampling was used to select 18 hospitals out of 39 hospitals from 5 zones.
Standard assessment Proforma developed by John Hopkins School of Public Health for assessing compliance to
Tobacco-Free Law was used and modified to address certain aspects of Section-4, 5 and 6 of COTPA. Hospital campuses
were assessed by dividing them into zones like hospital buildings, office buildings, public places outside the hospital
and residential areas. Result: Signs of active tobacco use observed in 40.6% of hospital buildings, 35.3% in office
buildings, and 75.4% in public places outside the buildings. ‘No smoking signage was not as per the COTPA guidelines
in 21.4% of the hospitals and 72% were not tobacco free outdoors in these positions. Conclusion: The study highlighted
a lower compliance rate than expected which raises questions on law enforcement concerning tobacco. Hence necessary
measures have to be used up for sustained awareness campaigns, backed by enforcement drives. Periodic compliance
surveys will strengthen the implementation of tobacco free legislation in health care institutions.


Main Subjects