BACKGROUND: India is a leader in public health initiatives, particularly in tobacco control. Significant progress has been made in reducing tobacco use nationwide through the Cigarettes and Other Tobacco Products Act (COTPA, 2003). However, at the subnational level, challenges persist. Maharashtra, a major tobacco producer and a state where various types of tobacco are consumed, faces significant implementation and enforcement issues, especially in rural areas.
METHODS: This scoping review examined state and national level policies for controlling tobacco smoking in Maharashtra and India as part of a multi-country initiative on identifying policy priorities for tobacco control and improving air quality. Studies published in English since 2003 were included through a search of electronic databases including PubMed, Scopus, and Google Scholar. Grey literature was consulted through online institutional sources. Qualitative and quantitative studies, analyses and reports on tobacco control policies from India and Maharashtra were included. Data were extracted using a standardized template and analyzed thematically. Findings will be discussed with state-level stakeholders, highlighting policy implementation, barriers, facilitators, and priorities.
RESULTS: The review included 25 studies. Barriers for policy implementation in the state include tobacco industry interference and inadequate enforcement in rural regions. Challenges such as non-uniform adherence to tobacco-free school policies, loose cigarette sales, and gaps in cessation services were also noted.
Measures like the Tobacco-Free Village program and enforcement of COTPA regulations in urban areas indicate progress and offer lessons for scaling up.
CONCLUSIONS: The literature presents recommendations such as an AI-powered compliance monitoring platform to detect tobacco regulation violations and implementing incentive-based schemes (tax breaks or microloans) to encourage vendors to transition away from tobacco sales. Findings from this review will be used for an in-person stakeholder workshop and survey on identifying priorities for advancing tobacco control in Maharashtra.