Research paper
CC-BY-NC 4.0

Awareness and compliance to anti-smoking law in South Bengaluru, India

Pradeep S. Banandur 1  ,  
National Institute of Mental Health and Neuro Sciences, (NIMHANS), Bengaluru, India
Tob. Prev. Cessation 2017;3(September):123
Publish date: 2017-09-14
Submission date: 2016-10-24
Final revision date: 2017-07-01
Acceptance date: 2017-08-21
Tobacco smoke affects the health of non-smokers by exposure to second-hand smoke (SHS). The Indian Cigarettes and Other Tobacco Products (COTPA) Act 2003 Section 4 aims to reduce exposure to SHS. Awareness and compliance to COTPA are key to achieving its intended outcome. We assessed: a) awareness among persons responsible for compliance (PRC) and authorized officers (AO), and b) compliance of public places to COTPA in South Bengaluru, India.

A cross-sectional assessment of public places in South Bengaluru was conducted using time-location sampling. The Johns Hopkins Bloomberg School of Public Health’s observational and interview checklist was used to assess compliance of public places to COTPA and awareness of COTPA among PRC/AO, respectively.

Among 359 public places, one-third of the public places showed complete (1.9%) or partial compliance (28.1%). The majority (93%) of the PRCs and all AOs were aware of COTPA. However, they lacked information on the different provisions of the Act. Violations like persons smoking (3.9%), visible ashtrays (6%) and cigarette butts (13%) were noted more among eateries compared to other public places. Among those public places supposed to have designated smoking-areas, only 19% complied.

This is the first representative survey of awareness and compliance of COTPA in Bengaluru City. Low compliance, coupled with the lack of appropriate awareness among PRCs and AOs about COTPA, demands a comprehensive strategy to enhance awareness. Comprehensive efforts towards making all stakeholders understand the health impacts of smoking, and strict enforcement, might facilitate effective implementation of COTPA.

Pradeep S. Banandur   
National Institute of Mental Health and Neuro Sciences (NIMHANS), 560029 Bengaluru, India.
1. Tobacco use fact sheet WHO. Available at: (accessed September 2016).
2. Economic Burden of Tobacco Related Diseases in India. Available at: (accessed September 2016).
3. Health worker Guide. Available at: (accessed September 2016).
4. The Health Consequences of Smoking—50 Years of Progress A Report of the Surgeon General. Available at: (accessed September 2016).
5. Health CO on S and. Smoking and Tobacco Use; Fact Sheet; Secondhand Smoke . Smoking and Tobacco Use. Available at: (accessed September 2016).
6. WHO | WHO report on the global tobacco epidemic, 2011. WHO. Available at: (accessed September 2016).
7. WHO | Second-hand smoke [Internet]. WHO. Available at: (accessed September 2016).
8. GATS India. Global Adult Tobacco Survey, India 2009-2010 [Internet]. Available at: (accessed September 2016).
9. Guidelines for implementation of Smoke Free Rules (Section 4) and Tobacco Free Educational Institutions (Section 6) of COTPA 2003 [Internet]. Available at: (accessed September 2016).
10. Goel S, Ravindra K, Singh RJ, Sharma D: Effective smoke-free policies in achieving a high level of compliance with smoke-free law: experiences from a district of North India. Tob Control. 2014;23(4):291–4. doi: 10.1136/tobaccocontrol-2012-050673
11. Tripathy JP, Goel S, Patro BK. Compliance monitoring of prohibition of smoking (under section-4 of COTPA) at a tertiary health-care institution in a smoke-free city of India. Lung India Off Organ Indian Chest Soc. 2013;30(4):312–5. doi: 10.4103/0970-2113.120607
12. Resource Guide: Time Location Sampling (TLS) 2nd Edition. Available at: (accessed September 2016).
13. Epi InfoTM | CDC [Internet]. Available from: (accessed September 2016).
14. Assessing Compliance with Smoke-Free Laws May 2014 A “How-to” Guide for Conducting Compliance Studies Second Edition. Available at: (accessed September 2016).
15. COTPA Sec 4: Prohibition of Smoking in Public Places. Available at: (accessed September 2016).
16. López MJ, Fernández E, Gorini G, Moshammer H, Polanska K, Clancy L, et al. Exposure to Secondhand Smoke in Terraces and Other Outdoor Areas of Hospitality Venues in Eight European Countries. PLOS ONE. 2012 Aug 1;7(8):e42130. doi: 10.1371/journal.pone.0042130
17. Kumar R, Goel S, Harries AD, Lal P, Singh RJ, Kumar AMV, et al. How good is compliance with smoke-free legislation in India? Results of 38 subnational surveys. Int Health. 2014 Sep;6(3):189–95. doi: 10.1093/inthealth/ihu028
18. Naiman AB, Glazier RH, Moineddin R. Is there an impact of public smoking bans on self-reported smoking status and exposure to secondhand smoke? BMC Public Health. 2011;11:146. doi: 10.1186/1471-2458-11-146
19. Lee K, Hahn EJ, Robertson HE, Lee S, Vogel SL, Travers MJ. Strength of smoke-free air laws and indoor air quality. Nicotine Tob Res. 2009 Apr;11(4):381–6. doi: 10.1093/ntr/ntp026
20. Shopland DR. Tobacco use and its contribution to early cancer mortality with a special emphasis on cigarette smoking. Environ Health Perspect. 1995 Nov;103(Suppl 8):131–42. doi: 10.1289/ehp.95103s8131
21. D’Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008 Feb 12;117(6):743–53. doi: 10.1161/circulationaha.107.699579
22. Vineis P, Caporaso N. Tobacco and cancer: epidemiology and the laboratory. Environ Health Perspect. 1995 Feb;103(2):156–60. doi: 10.1289/ehp.95103156
23. Bosetti C, Gallus S, Peto R, Negri E, Talamini R, Tavani A, et al. Tobacco smoking, smoking cessation, and cumulative risk of upper aerodigestive tract cancers. Am J Epidemiol. 2008 Feb 15;167(4):468–73. doi: 10.1093/aje/kwm318
24. Hu T-W, Lee AH, Mao Z. WHO Framework Convention on Tobacco Control in China: barriers, challenges and recommendations. Glob Health Promot. 2013 Dec;20(4):13–22. doi: 10.1177/1757975913501910
25. Kumar R, Lal P, Satyanarayana S, Singh R, Wilson N, Chauhan G. Assessing compliance to smoke-free legislation: results of a sub-national survey in Himachal Pradesh, India. WHO South-East Asia J Public Health. 2013;2(1):52. doi: 10.4103/2224-3151.115843
26. Kaur P, Thomas DR, Govindasamy E, Murhekar MV. Monitoring smoke-free laws in restaurants and educational institutions in Chennai, India. Natl Med J India. 2014 Apr;27(2):76–8.
27. Goel S, Singh R, D S, A S. Public opinion about smoking and smoke free legislation in a district of North India. Indian J Cancer. 2014;51(3):330. doi: 10.4103/0019-509x.146788
28. Fernández E, Fu M, Pascual JA, López MJ, Pérez-Ríos M, Schiaffino A, et al. Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study. PloS One. 2009;4(1):e4244. doi: 10.1371/journal.pone.0004244
29. Gleich F, Mons U, Pötschke-Langer M. Air Contamination Due to Smoking in German Restaurants, Bars, and Other Venues—Before and After the Implementation of a Partial Smoking Ban. Nicotine Tob Res. 2011 May 26;ntr099. doi: 10.1093/ntr/ntr099