Background:
Considering the magnitude of the tobacco menace, India ratified the FCTC in 2004, becoming the seventh country to do so. Following this, Tobacco control has been implemented in India for more than a decade, through comprehensive tobacco control legislation like Cigarette and Other Tobacco Products Act (COTPA). Implementation is being ensured by the extensive lobby by civil society or judicial interventions. There has been a delay in achieving the outcomes as obligated by FCTC. Therefore, it is crucial to understand and document civil society perspectives on the status of tobacco control in India, to accelerate the process, which is explored in the present study.

Methods:
This was an exploratory study conducted using purposive sampling. Pioneering experts (n= 9) who were actively working in tobacco control in the state of Tamil Nadu, India for more than a decade, were interviewed with their consent, using a semi-structured interview schedule. The interview was audio-recorded, transcribed and analysed using thematic analysis.

Results:
The activists report that unlike other major public health issues, tobacco control is given least priority across the country, thus resulting in poor enforcement of tobacco control policies. Five major themes emerged as challenges to tobacco control; enforcement, industry interference, awareness, cessation services and media. Though the experts perceive that tobacco control is possible, industry interference on the judiciary, executive and legislative level is a major hindrance at present. The results also highlight that lack of interdepartmental co-ordination among different departments responsible for enforcement and their ignorance about their role in tobacco control is also a deterrent. Need for establishing cessation facilities were felt crucial.

[Perspectives of Tobacco Control Experts]



Conclusions:
Tobacco industry interference is a big challenge for tobacco control in India. However, the experts are optimistic about making tobacco control a reality.