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Banning tobacco sales and advertisements near educational institutions may reduce students’ tobacco use risk: evidence from Mumbai, India
  1. Ritesh Mistry1,2,3,
  2. Mangesh Pednekar4,
  3. Sharmila Pimple5,
  4. Prakash C Gupta4,
  5. William J McCarthy1,2,
  6. Lalit J Raute4,
  7. Minal Patel1,
  8. Surendra S Shastri5
  1. 1Division of Cancer Prevention and Control Research, University of California, Los Angeles, USA
  2. 2Department of Health Policy and Health Management, University of California, Los Angeles, USA
  3. 3Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA
  4. 4Healis Sekhsaria Institute for Public Health, Navi Mumbai, India
  5. 5Department of Preventive Oncology, Tata Memorial Hospital, Mumbai, India
  1. Correspondence to Dr Ritesh Mistry, Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH I, Room 3806, Ann Arbor, MI 48109–2029, USA; riteshm{at}


Background India's Cigarettes and Other Tobacco Products Act bans tobacco sales and advertisements within 100 yards of educational institutions. In school-adjacent neighbourhoods in Mumbai, we assessed adherence to these policies and whether tobacco vendor and advertisement densities were associated with students’ tobacco use.

Methods High school students’ tobacco use was measured using a multistage cluster sampling survey (n=1533). Field geographic information systems data were obtained for all tobacco vendors and advertisements within 500 m of schools (n=26). Random-effects multilevel logistic regression was used to estimate associations of tobacco vendor and advertisement densities with ever tobacco use, current smokeless tobacco use and current tobacco use.

Results There were 1741 tobacco vendors and 424 advertisements within 500 m of schools, with 221 vendors (13%) and 42 advertisements (10%) located within 100 m. School-adjacent tobacco vendor density within 100 m was not associated with the tobacco use outcomes, but tobacco advertisement density within 100 m was associated with all outcomes when comparing highest to lowest density tertiles: ever use (OR: 2.01; 95% CI 1.00 to 4.07), current use (2.23; 1.16, 4.28) and current smokeless tobacco use (2.01; 1.02, 3.98). Tobacco vendor density within 200, 300, 400 and 500 m of schools was associated with current tobacco use and current smokeless tobacco use, but not ever use.

Conclusions The tobacco sales ban near educational institutions could be expanded beyond 100 m. Greater enforcement is needed regarding the current bans, particularly because advertisement density within 100 m of schools was associated with all students’ tobacco use outcomes.

  • Advertising and Promotion
  • Low/Middle income country
  • Public policy
  • Global health
  • Prevention

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