# COTPA Section 4 Compliance in Udupi City Municipal Corporation: An Exploratory Survey From Coastal Karnataka

## TL;DR

This study examines how well public places in Udupi, India, follow the law banning smoking in public areas.

## Contribution

The study provides a detailed assessment of COTPA Section 4 compliance in a specific Indian city using observational data.

## Key findings

- Only 38% of public places in Udupi were compliant with smoke-free regulations.
- Healthcare facilities and recreational venues showed the highest compliance, while marketplaces and government offices had the lowest.
- Lack of signage was the main reason for non-compliance, observed in 48% of sites.

## Abstract

The Cigarettes and Other Tobacco Products Act (COTPA), 2003, prohibits smoking in public places under Section 4 to protect individuals from second‐hand smoke (SHS). However, compliance with this provision remains inconsistent across India.

To assess compliance with Section 4 of COTPA in public places in the Udupi City Municipal Corporation (UCMC) of Karnataka.

A cross‐sectional observational study assessed compliance with smoke‐free regulations in 189 public places selected by convenience sampling using a structured observational checklist. Compliance was categorised as full, partial, or non‐compliant. Data were analysed using descriptive statistics, chi‐square tests with Bonferroni‐adjusted post hoc analyses and binary logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs).

Of 189 sites, 38% were compliant (17.5% fully and 20.5% partially), while 62% were non‐compliant, primarily due to absent signage (48%); active smoking was observed at 14%. Place category significantly predicted compliance (p  < 0.001), with higher adherence in recreational venues (90%) and healthcare facilities (86.7%). Educational institutions, government offices, hospitality venues and hotels showed substantial non‐compliance (45.5%–51.8%) and significantly lower odds of compliance compared with healthcare facilities (ORs 0.09–0.15). Marketplaces exhibited very poor compliance (77.8% non‐compliant; OR = 0.03), while transportation hubs and religious sites were uniformly non‐compliant due to the absence of mandated signage.

The findings highlight the need for stronger enforcement, routine monitoring and targeted awareness initiatives to improve compliance with smoke‐free legislation and protect public health.