Government's pro-public health policies and effective coordination is key for success in tobacco control - a case study from Himachal Pradesh in India
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Indira Gandhi Medical College, Hospital Administration, India
National Health Mission, NCD, India
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A617
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Background and challenges to implementation:
Himachal Pradesh (Pop: 7 million) is a state in northern part of India. More than one-fifth of adult population in the State is tobacco user. State is not covered under India's National Tobacco Control Programme; as a result the state had major resource constraints in terms of manpower, finance and technical expertise. However, an effective collaboration between the state government, network of local NGOs (HPVHA) and The Union- an International organization worked very well and state became a model for tobacco control in India.

Intervention or response:
HPVHA generated massive awareness among general public about the issue, strategically carried out political advocacy with policy makers. The Union provided funding and technical assistance. Government issued relevant circulars, notified squads and simplified the enforcement procedures.

Results and lessons learnt:
Collaborated efforts resulted in setting up of an institutional framework. Stringent enforcement was carried out across the state. Till May 2017, more than 100,000 violations has been reported and near Rs 11 million has been collected as fine amount which is further utilized for tobacco control activities. TAPS violations at points of sale are nearly rooted out from the state. First conviction in the country under for TAPS violations, pictorial health warnings on tobacco packs and gutkha ban was carried out in the State. Based upon the findings of compliance survey on an International protocol, the state of Himachal Pradesh was declared “smoke free” in July 2013 by Health Minister. WHO awarded HPVHA and State government in the year 2011 and 2012 respectively for implementing tobacco control policies effectively.

Conclusions and key recommendations:
State Government's pro-public health policies formulation and implementation and strategic collaboration between Government and NGOs are always vital for successful implementation of any public health initiative as demonstrated in State of Himachal Pradesh. This model can be replicated in other states in India or other developing countries with similar settings.

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