Unveiling Tobacco Vendor Practices: Assessing the Knowledge of and Compliance With Cigarettes and Other Tobacco Products Act (COTPA) Sections Five and Six at the Point of Sale in Raebareli, India

Background Tobacco use is one of the major public health issues in India, with 28.6% of adults using tobacco according to the Global Adult Tobacco Survey-2. The Cigarettes and Other Tobacco Products Act (COTPA) 2003 aims to curb tobacco use through restrictions on advertising (section five) and sales to minors and near educational institutions (section six). This study assessed tobacco vendors' knowledge and compliance with these provisions in Raebareli, Uttar Pradesh, a tier II city, to identify gaps in implementation. Methods A community-based cross-sectional study was conducted from July to December 2023 in Raebareli's 35 municipal wards, covering 2.8 lakh residents. Using convenience sampling, 244 tobacco vendors were included. Data were collected via a structured proforma containing vendor demographics, knowledge of COTPA (12 questions), and compliance with sections five and six (nine questions). Knowledge and compliance scores were categorized as adequate (>50%) or inadequate. Univariate and multivariable logistic regression analysed associations with sociodemographic factors and operational profile of the shops, using IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, United States). Results Of 244 vendors, 197 (80.7%) had inadequate knowledge, with only seven (2.9%) aware of the 100-yard school distance rule and awareness about the single cigarette sale ban was nil. Compliance was inadequate in 120 (49.2%) vendors, with 229 (93.9%) openly displaying tobacco and only four (1.6%) showing signage prohibiting sales to minors. Higher education (adjusted odds ratio or AOR=4.117, p=0.011) and exclusive tobacco vending (AOR=2.606, p=0.014) predicted better knowledge, while permanent shops (AOR=2.343, p=0.036) and mixed-product sales (AOR=2.093, p=0.027) predicted higher compliance. Conclusion Low knowledge and compliance with COTPA in Raebareli highlight enforcement gaps. Targeted education and stricter monitoring are needed to enhance adherence and compliance.