Gupta Rakesh, Bhatt Garima, Singh Ranjit, Chahar Puneet, Goel Sonu, Singh Rana J
Rajasthan Cancer Foundation and Honorary Consultant, Tobacco Cessation, Santokba Durlabhji Memorial Hospital & Medical Research Institute, Jaipur, Rajasthan, India.
Enforcement, Tobacco Control, Vital Strategies, New Delhi, India.
Indian J Tuberc. 2025 Jan;72(1):94-97. doi: 10.1016/j.ijtb.2024.06.007. Epub 2024 Jun 15.
The 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.
Enforcement 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.
For 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.
In 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.
公共卫生项目取得成功的关键在于其成功实施以实现预期成果。对于整合诸如《香烟及其他烟草制品法案》（COTPA）之类的立法措施而言，这需要一个执法环节，除非被指定机构能实现最佳参与并获得授权，否则其成果充其量可能是薄弱且不完整的。
尽管全国各州烟草控制小组（STCCs）已尽最大努力，但在国家烟草控制计划（NTCP）下，COTPA的执法仅取得了部分成功。缺乏执行计划、被指定机构培训计划不规律且缺乏主人翁意识、包括民间社会（CSOs）在内的利益相关者参与度欠佳、直到最近都缺少对其产出的监测与评估，以及最重要地，COTPA中缺少对未履行职责的问责条款，这些都导致了合规情况参差不齐但大多不佳。
为成功执行COTPA，卫生与家庭福利部（MoHFW）除了应考虑多项研究提出的综合解决方案外，还应考虑修订COTPA并加强现有烟草控制措施，比如在州一级设立专门的COTPA执法警察部队、成立一个国家烟草控制组织（NTCO）或者将其完全委托给第三方。
在印度，严格执行COTPA对于减轻烟草负担至关重要。卫生与家庭福利部除了尽早修订COTPA外，还应特别专注于采用提议的注重成果的战略。否则，它应考虑在2030年前为实现印度烟草问题的最终解决而努力。
