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

Objective: Tobacco-free policies in hospital campus reduce exposure to tobacco smoke; change the demeanour ofthe professionals, patients and people visiting hospitals towards tobacco use. Section-4, 5 and 6 of COTPA (Cigarettesand Other Tobacco Products Act) necessitates the need for implementation of the prohibition on smoking in publicplaces. Against this background, the present work was designed to evaluate the status of compliance Section 4, 5 and6 of COTPA in Delhi Government hospitals Methods: A cross-sectional observational study was conducted withinGovernment 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 toTobacco-Free Law was used and modified to address certain aspects of Section-4, 5 and 6 of COTPA. Hospital campuseswere assessed by dividing them into zones like hospital buildings, office buildings, public places outside the hospitaland residential areas. Result: Signs of active tobacco use observed in 40.6% of hospital buildings, 35.3% in officebuildings, and 75.4% in public places outside the buildings. ‘No smoking signage was not as per the COTPA guidelinesin 21.4% of the hospitals and 72% were not tobacco free outdoors in these positions. Conclusion: The study highlighteda lower compliance rate than expected which raises questions on law enforcement concerning tobacco. Hence necessarymeasures have to be used up for sustained awareness campaigns, backed by enforcement drives. Periodic compliancesurveys will strengthen the implementation of tobacco free legislation in health care institutions.