title: How good is compliance with smoke-free legislation in India? Results of 38 subnational surveys.
abstract: BACKGROUND
  India has been implementing smoke-free legislation since 2008 prohibiting smoking in public places. This study aimed to assess the level of compliance with smoke-free legislation (defined as the presence of no-smoking signage and the absence of active smoking, smoking aids, cigarette butts/bidi ends and smoking smell) and the role of enforcement systems in Indian jurisdictions.
  
  
  METHODS
  This was a cross-sectional, retrospective review of reports and primary data sheets of surveys conducted in 38 selected jurisdictions across India in 2012-2013.
  
  
  RESULTS
  Of 20 455 public places (in 38 jurisdictions), 10 377 (51%) demonstrated full compliance with smoke-free law. Educational institutions and healthcare facilities performed well at 65% and 62%, respectively, while eateries and frequently visited other public places (such as bus stands, railway stations, shopping malls, stadia, cinema halls etc.) performed poorly at 37% and 27%, respectively. Absence of no-smoking signage was the largest contributor to non-compliance across all types of public places. Enforcement systems were present in all jurisdictions, but no associations could be demonstrated between these and smoke-free compliance.
  
  
  CONCLUSIONS
  Smoke-free compliance in public places in India was suboptimal and was mainly related to the absence of no-smoking signage. This warrants further pragmatic and innovative ways to improve the situation.
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi 110016, India RKumar@theunion.org.
authors.forename: Ravinder
authors.initials: R
authors.lastname: Kumar
authors.affiliation: School of Public Health, PGIMER, Chandigarh, India.
authors.forename: Sonu
authors.initials: S
authors.lastname: Goel
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi 110016, India.
authors.forename: Pranay
authors.initials: P
authors.lastname: Lal
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi 110016, India.
authors.forename: Rana J
authors.initials: RJ
authors.lastname: Singh
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi 110016, India.
authors.forename: Ajay M V
authors.initials: AM
authors.lastname: Kumar
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi 110016, India.
authors.forename: Nevin C
authors.initials: NC
authors.lastname: Wilson
mesh_terms: D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods; D019983:Guideline Adherence; D006801:Humans; D007194:India; D035846:Law Enforcement; D008123:Location Directories and Signs / Q000706:statistics & numerical data; D011633:Public Facilities / Q000331:legislation & jurisprudence*; D011634:Public Health / Q000331:legislation & jurisprudence*; D012189:Retrospective Studies; D012907:Smoking / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D017132:Workplace / Q000331:legislation & jurisprudence
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Challans; Enforcement systems; India; Operational research; Smoke-free legislation