Guidelines for Tobacco Free Educational Institution

Introduction

As per second Global Adult Tobacco Survey (GATS-2, 2017) which was conducted by World Health Organisation (WHO) and Government of India, 28.6% adults (15+ years), 42.4% male and 14.2% female consume tobacco. 21.4% adults use smokeless/chewing tobacco while 10.7% use smoking forms. Khaini and bidi are most commonly used tobacco products. 11% adults consume khaini while 8% smoke bidi. Tobacco use prevalence decreased by 6% points from 34.6% in GATS-1 (2009-10) to 28.6% in GATS-2 which indicates that tobacco control efforts are in right direction. As per data of GYTS-4, 8.5% students of age 13-15 years use tobacco in one or other form in India. While, 18.1% students of this age ever tried tobacco products. Almost 70% of students who smoke cigarettes bought it from pan shop/vendors.

Given that the GYTS and GATS indicated that there is significant tobacco use among adolescents and young adults as they are most vulnerable to the exposure to tobacco use, the Government of India had released\launched\prepared the “Guidelines for Tobacco Free Schools/Educational Institutions” in 2008 and “Step by Step Guidelines for implementation of Section 6 (b) of the Act and Rules” in 2017. Many new initiatives have since been taken. The GATS2 data has also suggested that there is need to review the earlier guidelines, hence these guidelines.

Objective of these Guidelines is to provide a fresh momentum to implementation of tobacco control initiatives among adolescents and young adults. These guidelines may be implemented by any educational institution, including schools at all levels, colleges for higher or professional education and universities, both in public and private sector.

Implementation of theses guidelines should result in :

• More awareness about harmful effects and long-term health impact of tobacco use amongst the students, teachers, workers and officials in educational institutions.
• Awareness about various avenues available for tobacco cessation.
• A healthy and tobacco free environment in educational institutions and all educational institutions becoming tobacco free.
• Better implementation of legal provisions regarding sale and use of tobacco products, especially those related to educational institutions, public places, statutory warnings and minors.

These guidelines provide a framework for achieving the above-mentioned objectives. Apart from specifying the factors for a Tobacco Free Educational Institution (ToFEI), these guidelines also detail the roles and responsibilities for various stakeholders.

Tobacco Free Educational Institution

An Educational Institution (EI) should display “Tobacco Free Educational Institution” signage as specified in Annexure II in the premises of the EI; and a “Tobacco Free Area” signage as specified in Annexure III outside the EI. The signage could be in the form of boards or wall paints. It may be noted that the formats given in the Annexures II and III are only suggestive. The Educational Institution is encouraged to innovate or adapt the signage according to their capacity and context. Care should also be taken to communicate the correct intended message while customizing the signage. The signage should be displayed in the language of instruction in the Educational Institution and also in the local language if it is so possible.

The signage should be displayed at prominent places outside and in the premises such as on the boundary wall, the main entrance, the official notice boards and any such place where the management thinks that these would communicate the intended message effectively. The Educational Institution should designate Tobacco Monitor(s) from amongst their staff, an official or a teacher or a student representative (the student from class IX onwards). Health & Wellness Ambassadors should also be designated as Tobacco Monitors. The name, designation and phone number of the Tobacco Monitor(s) should also be mentioned on the signages. Multiple Tobacco Monitors may be designated and in-fact it might be a good idea to do so. For example – appointment of a Tobacco Monitor for each class from amongst the students in the class. Participation of the most important stakeholder, the students of secondary school (classes IX to XII), would be key to successful implementation of the initiative. Care should be taken that tobacco users may not be designated as Tobacco Monitors.

The EI management should ensure that no tobacco products are sold inside the premises and in an area within a 100 yards from the premises. Any violation should be reported to the National Quitline at 1800-11-2356. The Management should also, if possible, with the help of local law enforcement authorities and community, including parents, make efforts to stop such sales. It may be noted that the Head of the Institution is also authorized to collect fine for violation of section 6(b), sale of tobacco products within 100 yards of an educational institution. EI should also with the help of local authorities mark such boundaries /area which clearly defines the 100 yards area to ensure that no tobacco products are sold within marked area.

The EI management must not permit any use of tobacco products in the premises of the institution by anybody, including students, teachers, other staff members, school buses’ drivers & staff and visitors. Observance of the “No Tobacco Use” norm should be included in EI’s code of conduct guidelines and action should be taken against such violations as per EI’s internal policy. This may include community service, information to and discussions with parents. Another suggestion is to make tobacco users ineligible for the Student\Teacher\Staff of the Year Award or other awards given for co-curricular excellence. Since the premises of all EIs by their nature are public places, smoking inside the premises of an EI is a violation of section 4 of the COTPA. The Head of all Educational Institutions are also authorized to impose and collect fine under the COTPA, 2003 for such violations.

The Food Safety and Standards (Prohibition and Restrictions on Sales) Regulation, 2011 prohibits the use of tobacco and nicotine as ingredients in food products and as such various States have issued necessary orders for prohibiting the sale of Gutkha and Pan Masala (containing tobacco or nicotine). In 2016, communication was sent to all States/UTs to pass necessary orders in compliance of the Hon`ble Supreme Court order dated 23.09.2016 and ensure that the manufacture, storage, distribution or sale of gutkha and pan masala (containing tobacco or nicotine) and any other products marketed separately having tobacco or nicotine in the final product by whatever name called, whether packaged or un-packaged and/or sold as one product, or though packaged as separate products, sold or distributed in such a manner so as to easily facilitate mixing by the consumer is prohibited in the jurisdiction of the respective States. Though Pan Masala without tobacco and/or nicotine is a standardized product under the Food Safety and Standards Act, 2006 and Regulations made there under, it may be noted that it is injurious to health and its use should be discouraged.

The EI should also help tobacco users and tobacco addicts to quit tobacco by encouraging them to avail the Quitline services and mCessation services. Information about these services can be obtained from the Quitline. A ToFEI must not participate in any event sponsored by any firm or a subsidiary of a firm or a seller, which promotes the use of or manufactures or sells tobacco products in any form. EIs/ Students should also not accept any prize or scholarship instituted by such firms.

The EI management and the Tobacco Monitors must also be vigilant to note the tobacco substitutes such as e-cigarettes and the like devices viz. Heat-Not-Burn devices, Vape, e-Sheesha, e-Nicotine Flavoured Hookah. Such products, though not tobacco products, are also harmful for health. E-cigarettes come in many shapes and sizes which look like regular cigarettes, cigars, pipes, pens, USB flash drives, with sleek high-tech design with re-chargeable batteries. These products are usually marketed as being safer alternatives for conventional cigarettes but such notion of safety is false. There is evidence that these products induce adolescents and young adults to nicotine use leading to addiction. Any use of such products on the campus may be reported to the Quitline.

The Institution may use the Self-Evaluation Scorecard for Tobacco Free Educational Institution given in Annexure IV, to assess the status of implementation of the ToEFI Guidelines in their institution on half-yearly basis and to get a certificate to this effect to those EIs who score 90% and above marks. Once the EI is satisfied that they have achieved the benchmark score, the EI can choose to participate in the ToFEI Award Scheme. A ToFEI Certificate will be awarded to a ToFEI if the EI’s score is found to be equal to or more than the benchmark score after verification. Details of the ToFEI Award Scheme will be issued separately by the MoHFW.

Tobacco Control activities in Educational institutions

The EI should undertake tobacco control activities from time to time. Some suggestive activities are as under –

• Assemblies for taking pledge against tobacco,
• Poster/slogan/essay/quiz/debate competitions and street plays etc. Posters so developed with information about the harmful effects of tobacco should be displayed at prominent places in the educational institution.
• The EI management should encourage tobacco control initiatives by students /teachers/ other staff and certificates of appreciation or awards may be given to those who take initiative and do good work in this regard.
• The EI should invite the local law enforcement authorities /and health authorities to be the part of school assembly and deliver an address on tobacco control. This will facilitate in advocating the policy makers on tobacco related issues.
• Marking of 100 yards area from the outer limit of boundary wall / fence of the EI.

The above list is only suggestive and the EI team should explore other options as well.

Roles & Responsibilities

Ministry of Health & Family Welfare – Tobacco Control Division (National Tobacco Control Cell)

• To ensure that communications/advisories are sent to State Tobacco Control Cell for monitoring these guidelines at regular intervals.
• IEC materials/ prototypes like posters, flip charts, brochures must be disseminated to States and uploaded on the NTCP website www.ntcp.nhp.gov.in
• To collaborate with Ministry of Human Resource Development (Department of School Education and Department of Higher Education) for inclusion of a chapter on the harmful effects of tobacco use in curricula.
• To develop a monitoring mechanism for evaluation and assessment of implementation of Guidelines for ToFEI through internal review mechanism.
• The National Cell will also put a mechanism in place for certification of EIs and for providing a Certificate to an EI that successfully reaches the benchmark score of 90/100.

State/District Tobacco Control Cell:

• Coordinate with State Education Departments (School / Higher / Technical / Medical Education) to institutionalize tobacco control by incorporating tobacco control activities in their Academic calendar. Efforts should also be made to make these guidelines a part of the terms and conditions for affiliation to the State Education Board.
• Coordinate with State Education Departments for sending circular to all Heads of Institutions to comply with the guidelines and permitting them to utilize the funds available under the untied grants available to Educational Institutions through government grants.
• District Authorities and Local Bodies should be encouraged to set up institutional mechanisms to facilitate implementation of these guidelines and monitoring and review implementation and also to provide support to managements of institutions taking initiative for helping enforcement of COTPA.
• To ensure the dissemination of these guidelines in all educational institutions in coordination with Education Departments. Funds under National Tobacco Control Programme can be utilized for this.
• To make efforts to get questions related to ‘Tobacco Free Educational Institution’ included in existing monitoring/inspection mechanism of Education Departments.
• To engage with Department of Rural Development/Urban Administration for setting up institutional mechanism for supervision and monitoring of these guidelines through Village Health, Sanitation & Nutrition Committees in rural areas and Mahila Arogya Samitis and Mohalla Samitis\Ward Sabhas in urban areas.
• Representatives of the State Education Departments (School / Higher / Technical / Medical Education) should be co-opted in the State and District Level Coordination Committees and status of implementation of these guidelines should be reviewed in each of their meetings.

Civil Society Organizations

Civil Society Organizations (CSO) can play a pivotal role in implementation of guidelines, specially in its dissemination and in building capacities of managements and teams in Educational Institutions. CSO can also support the STCCs, DTCCs and EIs by providing inputs such as technical assistance for IEC. The CSOs can also undertake assessment of implementation status of these guidelines in an EI and assist the institution in removing gaps in implementation or mobilize support from the local institutions, wherever necessary. The STCCs and DTCCs can and should look to actively partner with CSOs, wherever possible, for not only implementation but also for eliciting valuable feedback about implementation status and challenges, to effect course corrections.

Source : Ministry of Health & Family Welfare

Related resources

• Implementation Manual of Guidelines for Tobacco Free Educational Institution