Abstract
IntroductionThe key for public health programs to succeed is their successful implementation to achieve the desired outcomes. For integrating legislative measures such as the Cigarette and Other Tobacco Products Act (COTPA), which needs a component of enforcement, unless there is optimal engagement and empowerment of the assigned agencies, the outcomes are likely to be weak and incomplete at best. Current statusEnforcement of COTPA under the National Tobacco Control Programme (NTCP) has succeeded only partly despite the best efforts of State Tobacco Control Cells (STCCs) countrywide. The lack of an execution plan, irregularity in the training schedules of the assigned agencies which lack ownership, suboptimal engagement of the stakeholders, including civil societies (CSOs), missing monitoring and evaluation of their outputs until recently and, above all, an absence of an accountability clause in COTPA for non-performance have led to varied but mostly poor compliance. SolutionsFor successful enforcement of COTPA, the Ministry of Health & Family Welfare (MoHFW), besides integrated solutions proposed by several studies, should consider amending COTPA and strengthening the existing measures to control tobacco, such as setting of a dedicated COTPA-enforcement Police Unit at the State-level, a National Tobacco Control Organization (NTCO) or entrust it entirely to a third-party. ConclusionIn India, the strictest enforcement of COTPA is critical to reduce the burden of tobacco. The MoHFW, besides amending COTPA at the earliest, should specifically focus on adopting the proposed outcome-oriented strategies. Or else, it should consider working for an endgame of tobacco in India by the year 2030.
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