An observational study of compliance with tobacco-free school guidelines in Udupi district, Karnataka (India)

Background: National tobacco-free school guidelines were introduced in India in 2009. We assessed compliance with these guidelines across both government, government-aided, and private schools in Udupi district of Karnataka state in India. Methods: We visited 915 upper primary and high schools across Udupi district and used a standardized checklist for visual inspection of the school environment and interviews with a school representative to ascertain compliance with guidelines (display of a tobacco-free school/institution board, presence of no smoking signage, no tobacco sale within 100 yards, presence of a Tobacco Control Committee, integration of tobacco control activities into the school health program, and availability of a copy of Cigarettes and Other Tobacco Products Act). Results: A tobacco-free school board was displayed at the main entrance of 73% of schools, and there was no evidence of tobacco products on sale within 100 yards of 96% of schools. However, only 5% of the schools reported having the Committee; 4% reported having a copy of the Cigarettes and Other Tobacco Products Act, 2003 with the school, and no smoking signage was observed in < 1%. Integration of tobacco control activities into the school health program was reported in 91% of schools. Conclusions: Compliance with tobacco-free school guidelines in Udupi was far from complete, indicating the need for enhanced implementation and monitoring.