BACKGROUND: Non-Governmental Organizations (NGOs) are crucial for fighting India's tobacco epidemic through advocacy, cessation services, and public education. However, systemic, logistical, and socio-cultural barriers impede their effectiveness. This study explored the challenges faced by NGOs in tobacco control and provided actionable recommendations to enhance their participation in national efforts.
METHODS: The qualitative study was conducted through semi-structured interviews and focus group discussions with NGO representatives on the challenges that NGOs in tobacco control are facing across India. Fifteen NGO representatives were selected through purposive sampling, to ensure the maximum diversity of geographical locations and organizational focuses. Snowball sampling was then applied to reach additional participants who were relevantly experienced. The interviews and the focus group discussions were conducted via Zoom for 30-60 minutes and guided by a pre-tested interview protocol. All sessions were recorded and transcribed verbatim. The qualitative data were analysed thematically employing the Framework Method. Systematic coding and identifying themes were further facilitated by making use of the Atlas.ti software. Members checking and debriefing process was incorporated during the study to measure credibility.
RESULTS: Five key barriers affecting NGO participation were identified: Policy and Structural Barriers: Exclusion from decision-making and restricted access to government support; Resource Constraints: Financial instability, understaffing, and lack of technical training; Socio-Cultural Challenges: Community resistance, and cultural normalization of tobacco use; Coordination Gaps: NGOs and government agencies are not well aligned, resulting in fragmented efforts and Advocacy Challenges: Difficulties engaging policymakers and countering tobacco industry influence.
CONCLUSIONS: Overcoming these barriers requires strengthened NGO-government collaboration, increased financial and technical support, and active inclusion of NGOs in policymaking. Enhanced advocacy training and targeted strategies to address community resistance and cultural norms are essential. Integrating NGOs into policymaking processes, enhancing capacity-building efforts, and fostering cooperation with government departments will significantly strengthen tobacco control actions and accelerate progress toward national goals.