BACKGROUND: India has taken the lead in enforcing tobacco control policies and initiatives, aiming to safeguard public health. Consistent and ongoing efforts are required over time to ensure the success of tobacco control measures. The sustainability of tobacco control efforts is pivotal for moving toward a tobacco-free trajectory for the country.
METHODS: This index was developed through a literature review, followed by a modified Delphi technique among key experts representing various TC stakeholders and finally, all indicators were given operational definitions and illustrations based on a thorough review and expert feedback. Based on the indicators, the sustainability score was assessed in 27 states for the year 2022-23.
RESULTS: The institutionalisation of tobacco control was reported in 26 states and UTs. State Level Coordination Committee (SLCC) meeting held in five states and UTs. The institutionalisation of tobacco control in 90% or more districts was done in 24 states and UTs. District Level Coordination Committee (DLCC) meeting held in more than 75% of districts of 18 states. Robust enforcement mechanism was present in 25 states and UTs. Only 12 states reported the presence of a state-level coalition for tobacco control. seven states had TVL policies and 14 states had state-level policy on WHO FCTC policy guidelines.
CONCLUSIONS: This is a first-of-its-kind exercise at a sub-national level and could be used for future evaluations of the National Tobacco Control Programme in India. It highlights the key areas that require more convergence and efforts to advance sustainable tobacco control at the subnational level.