Tobacco Free Network - the actions of tobacco users and survivors: advocacy on enforcing tobacco control legislation and behavioural change in Tamil Nadu, India

Background and challenges to implementation Tobacco use is a major public health challenge in India with 275 million adults consuming different tobacco products, of which 28,064,400 people above the age of 15 y/o are in Tamil Nadu. Chewable tobacco is the most prevalent - India carries the highest amount of mouth cancer cases in the world and it is more common among women. India passed a ban on chewable tobacco in September 2016 but the implementation lacks enforcement. 90,3% of smokeless tobacco consumers reported no difficulty in purchasing banned chewable tobacco in Tamil Nadu. The Government of India has passed legislation for tobacco control but it is not rigorously implemented. This is attributed to a lack of awareness and penalties. For this reason advocacy, community-based action and social mobilisation are required. Intervention or response We have mobilised tobacco users and survivors throughout Tamil Nadu and formed a strong network for tobacco control. We equipped them with the skills for advocacy at the top level for sensitizing authorities and government officials. This was also enforced through advocacy in the media. Results and lessons learnt From January´16 until now we have mobilised 645 members. They are creating a domino-effect in their communities and at the higher level by spreading awareness about tobacco control legislation and the need for proper implementation. Organisations from the public and private sectors, as well as the media, are used as advocacy leverage because they provide a leeway into government officials which we can influence enforce the tobacco control legislation. Conclusions and key recommendations The network of tobacco users and survivors is a powerful means to sensitize health authorities and government officials and to advocate for the enforcement tobacco control legislation at the local, state and national level