Abstract
BACKGROUND: Tobacco use among Indian youth remains a significant public health concern, with a high prevalence of early initiation driven by accessibility, peer pressure, and targeted marketing. Despite legislative measures like the Cigarettes and Other Tobacco Products Act (COTPA), enforcement of the ban on tobacco sales within 100 yards of educational institutions remains inadequate. This study examines the factors influencing tobacco sales near schools in Telangana and Meghalaya, highlighting the urgent need for stronger regulations and monitoring to reduce youth exposure to tobacco products. METHODOLOGY: A cross-sectional study was conducted in seven districts of Meghalaya and Telangana, surveying 234 educational institutions selected through convenient sampling. Tobacco vendors within 100 yards of institutions were mapped and observed for compliance with Section 6 (b) of COTPA. Data on institution type, signage, and points of sale were collected through unannounced observations. Statistical analysis using descriptive statistics and Chi-square tests was performed in STATA 15.0 to identify factors influencing compliance. RESULTS: Among 234 institutions surveyed, 25% had tobacco sales within 100 yards, with higher prevalence in urban areas (30.6%) than rural (20.9%), and government institutions (31.1%) compared to private (21.1%). Middle and secondary schools had higher sales proximity (61.5% and 36.7%) than senior secondary (10.3%) or above (17.7%). Tobacco-free signage reduced sales prevalence (33.3% vs. 66.6%), and institutions with fewer than five PoS accounted for 80% of violations. CONCLUSION: This study highlights significant violations of COTPA Section 6 (b), with a deliberate clustering of tobacco retailers near government, middle, and secondary schools, particularly in urban areas. Weak enforcement, lack of tobacco-free signage, and targeted marketing exacerbate youth exposure to tobacco products, fostering early initiation and lifelong addiction. Strengthened regulatory enforcement, stricter penalties, improved monitoring, and youth-focused awareness campaigns are essential to curb tobacco sales near educational institutions and protect vulnerable populations.