Strengthening NCD care in Tumkur: an action research project

This project aimed to enhance implementation of the prevailing tobacco control policies, especially the Cigarette and Other Tobacco Products Act (COTPA). The project was executed in sequential phases. The project, over the time, adopted broad strategies of (1) sensitization of state level and district level stakeholders; (2) capacity building of enforcement agencies; (3) sensitization of journalists and use of mass media. The initial focus was at the state level where stakeholders from the various government departments (health; police; transport; education; information; fire safety etc.) were sensitized. During this time, a better understanding was developed working with these departments in terms of the specific role that each department could play and how COTPA implementation could be institutionalized. The project then moved its focus to the district level. Through experience and shared learning, an operational model was developed on how a district could achieve a high level of COTPA compliance by actions of several departments (and private stakeholders) within a duration of three to four months. Gadag became the first district that achieved high compliance to COTPA and where the model was refined. The project then expanded its coverage to one after another district. By early 2017, the project covered 24 districts. Based on the data generated by various government departments, these 24 districts achieved a high level of enforcement and compliance with COTPA. As part of the process, we worked with 11 government departments and trained over 4000 officers, mainly from the police and education departments. During the project duration, we also engaged in demanding newer and effective tobacco control policies (e.g. ban on Gutka and smokeless tobacco products, high taxation on tobacco products) and stricter implementation of existing policies. The comparison between the two rounds of the Global Adult Tobacco Survey conducted by the Ministry of Health and Family Welfare (Government of India) along with other partners reveal that between 2009-10 and 2016-17, the prevalence of the current tobacco use in Karnataka reduced from 28.2% to 22.8% – meaning there were about 9 lakh fewer tobacco users in 2016-17 compared to seven years ago. The prevalence of exposure to second-hand smoke (passive smoking) also reduced from 37.2% in 2009-10 to 23.9% in 2016-17. This project was primarily supported through grants from the Campaign for Tobacco-Free Kids.