BACKGROUND: Smoking and Tobacco Products Usage (Control) Act, 2005 bans tobacco advertisement completely; still, the companies flout the law in many ways. A review by Bangladesh Anti-Tobacco Alliance covering 8019 sales outlets in 944 locations across 45 districts found that almost 100% of the outlets had tobacco advertisements. British American Tobacco Bangladesh (96%) and Japan Tobacco International (87%) were found to be the worst offenders. Though the law was enacted long ago, its proper implementation is still poor due to lack of enforcement data. To address this, the status of banning smoking in public places, tobacco advertising, and pictorial health warnings was assessed under Sections 4, 5, and 10 of the Act. A report card was developed to highlight implementation gaps and propose actionable recommendations for policymakers.
METHODS: MPOWER policy of the World Health Organization has been adopted in this study, sans the ‘Offer help to quit’ portion. Data were collected from 30 districts using 60 questions divided into two questionnaires. Each contains 30 questions for interviews and observations. Questions were answered by two representatives of the task force of each district and six observation sites per district, including markets, hospitals, schools, malls, restaurants, and bus terminals. Scores ranged across the districts from risky (≤24%), unsatisfactory (25-34%), and average (35-44%) to satisfactory (45-60%) using the highest score of 300.
RESULTS: Among the 30 districts, 10% were satisfactory, 40% intermediate, 30% unsatisfactory, and 20% at risk. Jhenaidah was ranked highest with 50%, and Gaibandha was ranked lowest with 17%. While 73% of the districts satisfactorily implemented warning activities, 70% of them were at risk regarding advertising control.
CONCLUSIONS: Gaps in enforcement remain large, especially in tobacco advertising. These need regular mobile courts, training law enforcers, and effective surveillance. Public-private partnership and increased public awareness will help ensure better law enforcement for improved public health.