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

Abstract

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