|SECOND HAND SMOKING
|Year : 2010 | Volume
| Issue : 5 | Page : 39-42
Overview on the implementation of smoke-free educational institutions in Tamilnadu, India
Directorate of Public Health and Preventive Medicine, Government of Tamilnadu, 359, Anna Salai, Chennai - 600 006, Tamilnadu, India
|Date of Web Publication||9-Jul-2010|
T S Selvavinayagam
Directorate of Public Health and Preventive Medicine, Government of Tamilnadu, 359, Anna Salai, Chennai - 600 006, Tamilnadu
Source of Support: None, Conflict of Interest: None
'The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation Trade and Commerce, Production, Supply and Distribution) Act, 2003,' known as COTPA in short, was enacted by the Government of India to control the tobacco menace. One of the successful strategies adopted by the government of Tamilnadu for implementing this Tobacco Control Act was the concept of 'Smoke-free educational institutions'. The process for having smoke-free educational institutions was started by the NGOs motivating the school authorities, to ensure that the set of guidelines, which were devised based the COPTA Act, was followed. The institution was later certified as a smoke-free institution, after verification by the government. The role of the stakeholders and the challenges we faced are discussed in this article.
Keywords: The cigarettes and other tobacco products act, 2003, smoke-free educational institutions, tobacco control act
|How to cite this article:|
Selvavinayagam T S. Overview on the implementation of smoke-free educational institutions in Tamilnadu, India. Indian J Cancer 2010;47, Suppl S1:39-42
Publication of the supplement was supported by the funds from the 14th World Conference on Tobacco or Health, March 8-12, 2009, Mumbai. The Guest Editors, Editors, Authors and others involved with the journal did not get any financial or non-financial benefit from the sponsors.
| » Introduction|| |
As per the world health statistics 2008, report,  the non-communicable conditions will cause over three-quarters of all deaths in 2030. It is predicted that the four leading causes of death in the world, in 2030, will be ischemic heart disease, cerebrovascular disease (stroke), chronic obstructive pulmonary disease (COPD), and lower respiratory infections (mainly pneumonia). The use of tobacco is one of the reasons associated with the projected increase in these non-communicable diseases.
As per the WHO Report on the Global Tobacco Epidemic, 2008,  tobacco kills up to half of those who use it. In fact we can say that, tobacco use is one of the biggest public health threats the world has ever faced.
- There are more than one billion smokers in the world.
- The use of tobacco products is increasing globally, although it is decreasing in high-income countries.
- Almost half of the world's children breathe air polluted by tobacco smoke.
- The epidemic is shifting to the developing world.
- More than 80% of the world's smokers live in low- and middle-income countries.
- Tobacco use kills 5.4 million people a year - an average of one person every six seconds - and accounts for one in 10 adult deaths worldwide.
- Tobacco kills up to half of all users.
- It is a risk factor for six of the eight leading causes of deaths in the world.
As per the WHO report  second-hand tobacco smoke is dangerous to health. It causes cancer, heart disease, and many other serious diseases in adults. Almost half of the world's children breathe air polluted by tobacco smoke, which worsens their asthma condition and is a cause of dangerous diseases.
As per the Global Youth Tobacco Survey (GYTS) reports pertaining to India,  14.0% of students currently use any form of tobacco; 4.1% of the students currently smoke cigarettes; 11.8% currently use some other form of tobacco. Environmental Tobacco Smoke exposure is high - over one-quarter of the students live in homes where others smoke and two in five students are exposed to smoke around others outside of the home; more than one-third of the students have a parent who smokes, and 6.1% of the students have friends who smoke.
In this scenario, the Government of India notified in the gazette 'The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation Trade and Commerce, Production, Supply, and Distribution) Act (COTPA) 2003' and relevant rules,  to control this menace.
The Government of Tamilnadu has taken many initiatives in the implementation of this Act / rule, which has proved to be a successful model for the entire country. One of the strategies adopted is, 'smoke-free educational institutions,' which is impressive, visible, and sustainable, and can be replicated. The details are shared here for the benefit of others who are implementing the Act in their states and countries.
| » Methodology|| |
The smoke-free institution is the best / practical method to enforce Section 6 of the COPTA Act; in fact it is the objective of the implementation of a smoke-free institution. A smoke-free educational institution is committed to providing its students, employees, and visitors with a safe and healthy environment. No consumption of tobacco or tobacco products is allowed on any college property or in any college facility; this includes all buildings, grounds, sidewalks, and streets within the proper campus, including the hostels.
Why Smoke-free educational institutions?
- The rising trend of tobacco smoking among students in the country, there is a dire need to declare all educational institutions of the country smoke-free.
- Aggressive marketing of tobacco companies, which are particularly targeting youth.
- Youth being future of the nation should be safeguarded from playing with their lives and it is our duty to provide them a smoke-free environment.
- Tobacco litter desecrating the campus.
- Exposure to second-hand smoke (SHS).
We followed the steps listed herewith to create smoke-free institutions
- A state level 'Anti tobacco cell' meeting was organized under the chairmanship of the Principal Secretary to Government, Health and Family Welfare, for working out the modalities for implementation of the COTPA, 2003.
- Organized Workshops on 'Sensitization of Law Enforcers on Tobacco Control' for the health officials and law enforcers from other state departments, for effective enforcement of the COTPA, 2003.
- Government of Tamilnadu has issued a specific Government Order to implement the Act / rules and formation of enforcement squads at the state, district, block, and village levels, with authorized officials.
- The Director of Public Health and Preventive Medicine has issued guidelines to all Deputy Directors of Health Services and Health officers of the corporation and municipalities, for the effective enforcement of this Act and to coordinate with all other departments.
- Motivating the educational institutions to adopt the smoke-free policy in their premises and certify them after inspection by field public health staff, such as, Health inspectors and supervisors.
- Coordination and monitoring committees at the state and district levels were formed to ensure constant follow up.
The following guidelines were followed in implementing and declaring smoke-free educational institutions
- No sale of tobacco products inside the premises of educational institutions.
- No smoking and chewing of tobacco products inside the premises (as per section 4).
- Display of sign boards - No smoking area Smoking here is an offense - at least 60X30 cms in size, inside the institution at various places as required (as per section 4).
- No sale of tobacco products within a radius of 100 yards of the educational institutions (as per section 6).
- Display of Information, Education and Communication (IEC) materials inside the premises.
- Having the copy of the COPTA Act 2003 and its rules.
- Display of sign boards, 'Sale of tobacco products around the educational institutions within the radius of 100 yards is banned' (as per section 6), prominently near the main gate, on the outside face of the wall of the institution.
On the basis of the broad guidelines described earlier, the school authorities, teachers, and students were sensitized and motivated to take up tobacco control activities, particularly practice / enforce them in their own premises by adopting the 'smoke-free institution' concept.
The stakeholders in this activity were the school authorities, various local interested NGOs, the Cancer Institute, enforcement officials, particularly police authorities, and the Government of Tamilnadu, represented by the state tobacco control cell of the Director of Public Health and Preventive Medicine. The Cancer Institute along with the local NGOs started the process with the school authorities through discussion, and motivated them to take up the issue. The Government rendered all the technical and logistic support for this program. Once all the guidelines were fulfilled the school could approach them for certification. The government, after inspection, certified the institution to be a smoke-free educational institution. On many occasions, the certification process is celebrated as an event, to ensure a wider coverage through media, to motivate many more institutions.
The educational institutions, at least in the initial phase, are chosen based on their own interest, so that there is less resistance from the teaching faculty, students, and so on. This is moreso in the case of private schools, where the commitment of the school management has facilitated the process, but in the case of government schools, the support is much less.
Cooperation of enforcement authorities, particularly in ensuring no sale of tobacco products within 100 yards of schools, is difficult. This is particularly difficult if the school is situated in a commercial locality.
As per the Act book and IEC materials, it is not a big issue, but government educational institutions find it difficult to secure funds for keeping the boards as per provisions of the Act.
The initial enthusiasm dies after some time, as it is difficult to ensure continued motivation among the stakeholders.
Monitoring of the progress
Monitoring of the progress is done through regular inspection by the health inspectors, who are the enforcement agents from the state government. NGOs regularly visit and keep up the motivational level and also give us the status report.
In addition to the official route, we have established a core group of committed students in the school, who keep us updated on the status in their institution.
The actual expenses for creating and ensuring a smoke-free status did not require much money. It was mainly the commitment from the stakeholders. In our case, it all started with the NGOs, who motivated a few institutions to take on the issue. The cost of the Act book and the board, as per the Act, was taken care of by the schools themselves. The IEC materials were supplied by the government and NGO. Initial sensitization meeting expenses is mostly meet by the school and NGO. The certification event, which was mostly combined with many institutions in a particular locality, was taken care of by the government. For enforcement agencies, it was there routine duty. Transport cost was the main expenditure for all the stakeholders and it was mostly met from their own budget. We made suitable sanctions in the smoke-free Chennai project.
Agency for implementation
As stated already it was the combined effort of government, NGO, school authorities, and police department, where each one played their role. The NGOs initiated this process and the government utilized this opportunity.
How to ensure sustainability is the next issue we need to tackle and we decided that,
- Ideally it should be a voluntary effort of the educational institution, which itself will ensure sustainability.
- Institutions should develop and enforce its tobacco control policy.
- Heads of academic institutions should be held responsible to ensure that no one indulges in smoking on the premises of their respective institutions. At the time of admission to an educational institution, an undertaking should be taken from every student that if he / she during his / her tenure in the institution was found smoking, he / she would be expelled from the institution.
- The presence of smoke-free status should be considered as a point during the accreditation process, and should be issued certificates by the Health Department.
The State Government has started well and is going in the right direction. Within a short span of five months we can declare around 2000 educational institutions smoke-free, which include medical colleges, dental colleges, arts colleges, universities, schools, and so on; both public and private. At the same times we have made it clear that to ensure the expansion and sustainability of this program, we need the involvement of various government officials and non-governmental organizations in the enforcement / implementation of the Act.
In short, implementing a smoke-free institution concept ensures that section 6 of the COPTA Act is enforced in total. When all the educational institutions in a particular area are made smoke-free, there will be minimal number of tobacco selling outlets in that area, which will ensure that the consumption of tobacco will come down in the general public also.
| » References|| |
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|[Pubmed] | [DOI]|