Strategic prohibition of tobacco sale within 100 meters radius of health facilities in the absence of legal provisions in existing tobacco control act in Delhi

Background and challenges to implementation In India section 6 of Cigarette and Other Tobacco Products Act (COTPA) prohibits the sale of Tobacco products within the radius of 100 yards/ 100meters as per Delhi Act 1996 from any educational institute to protect the younger generation from tobacco habits, But at the same time large number of children and pregnant women with unborn children are also visiting health facilities including hospitals. Some tobacco vendors sitting outside walls of health facilities are a great threat for the visiting children and pregnant females which are to be protected from tobacco habits as well as from second hand smoke. Intervention or response Meeting held with all Chief District Medical officers(CDMOs), District Nodal Officers under Director Health Services &Sect Health. It was convinced that prohibition of sale of Tobacco is required within 100 meters radius of health facilities to protect children and pregnant ladies. In the absence of law, it was decided to implement this through an administrative order by each Chief District Medical Offices for respective district Health centres (dispensaries, polyclininc, mohalla clinic) and Medical superintendent of respective hospitals.awareness activity conducted & informed in community Results and lessons learnt All the CDMOs of 10 out of 11 districts issued administrative order in public health interest. These are applicable for nearly 300 health facilities. Orders are displayed at gates and notice boards . Incharges of health facilities nominated as nodal/implementing officers.Tobacco free zone boards & Nosmoking signage displayed in all dispensaries, polyclininc, mohalla clinic & in 21 out of 32 hospitals. The nodal officers are enforcing in public health interest with some resistance at few places which is being tackled strategically. Conclusions and key recommendations In the absence of legal provisions, if administration desires can implement public health measures strategically. Govt should consider to extend the provision of prohibition of tobacco sale under section6 to health facilities also