title: Awareness, attitude and perceived barriers regarding implementation of the Cigarettes and Other Tobacco Products Act in Assam, India.
abstract: BACKGROUND
  Tobacco use is a major public health problem in India. The Cigarettes and Other Tobacco Products Act (COTPA) was developed to curb this epidemic. Because no study has been conducted on the awareness, attitude and perceived barriers regarding the implementation of COTPA, this study was undertaken.
  
  
  METHODS
  A community-based cross-sectional survey was conducted among 300 adults (mean age 41 years, 52% men) selected by cluster sampling method from Guwahati Municipal Corporation. Information on awareness, attitude and their predictors and barriers for implementation was collected using a pretested, structured interview schedule. Multivariate analysis was done using SPSS.
  
  
  RESULTS
  Adults older than 50 years were 3 times (odds ratio [OR] 3.02, 95% CI 1.44-6.31) and those with more than 10 years of schooling were 4 times (OR 3.60, 95% CI 1.70-7.70) more likely to have good awareness of COTPA compared with their counter parts. Those belonging to the middle socioeconomic status (SES) were 3 times (OR 3.36, 95% CI 1.13-10.01), those who reported secondhand smoking harmful were 3 times (OR 3.32, 95% CI 1.45-7.62), and those with more than 10 years of schooling were 3 times (OR 2.92, 95% CI 1.01-8.45) more likely to have positive attitude toward COTPA compared with their counterparts. Lack of complete information and awareness of the Act, public opposition, cultural acceptance of tobacco use, lack of political support, and less priority for tobacco control were reported as barriers for COTPA implementation.
  
  
  CONCLUSIONS
  Efforts should be made to increase the awareness of COTPA focusing on younger population, less educated, and those belonging to the low SES.
authors.affiliation: Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum-695 011, India.
authors.forename: I
authors.initials: I
authors.lastname: Sharma
authors.forename: P S
authors.initials: PS
authors.lastname: Sarma
authors.forename: K R
authors.initials: KR
authors.lastname: Thankappan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055812:Community-Based Participatory Research; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult