Compliance to Tobacco Advertising and Promotion Ban in Four Regions of a Southern Indian State - A Descriptive Cross-Sectional Study.

Tobacco advertising and promotion influences youth smoking initiation and regular use. India's Cigarettes and Other Tobacco Products Act, 2003, bans tobacco advertising and promotion but allows Point of Sale (PoS) advertisements under specific conditions. This study aimed to assess compliance with the ban on tobacco advertising at the PoS in the Karnataka state of Southern India. A cross-sectional observational survey was conducted in 529 PoS across Karnataka's four administrative regions between January to March 2020 using a checklist. The research assistants visited shops selling tobacco products, observed each store during business hours for 10 minutes, and completed the checklist. Proportions and percentages were calculated for each domain of the checklist. The study showed that 127 (24%) shops out of 529 had direct PoS advertisements. Among the total violations, product showcases (94.5%), Stickers (76%), and Posters (75.6%) were prominently used for the promotion of tobacco products. Advertisements were seen more commonly in petty shops (92%) and urban areas (59.8%). Product displays, stickers, and posters were used most often to violate advertising laws. Compliance should be improved in urban and petty shops, to decrease tobacco product exposure and accessibility.