Pharmaceuticals and Personal Care Products (PPCPs) disposal practices in Tokha, Nepal: a health belief model study

BACKGROUND: Unused and expired Pharmaceuticals and Personal Care Products (PPCPs) are emerging environmental contaminants that may pose serious risks to human health and the environment. In Nepal, household and pharmacy level waste disposal behaviors remain poorly documented. METHODS: A cross-sectional survey was conducted in Tokha municipality among 298 households and 53 pharmacy retailers. Structured questionnaires included data on: (i) demographic features, (ii) usage and storage patterns of PPCPs, and (iii) their disposal practices. This study was based on the Health Belief Model (HBM) constructs. Data were analyzed using descriptive statistics, chi-square tests, Spearman's correlation analysis, and partial least squares structural equation modeling (PLS-SEM). RESULTS: Unsafe storage and improper disposal practices being common among households and pharmacy retailers. About 41.6% of the households stored unused or expired pharmaceuticals, primarily analgesics and skincare products that accounted 63.1% and 77.5%, respectively. Expired PPCPs were mostly disposed of in household garbage containers (88.9%) or burned (12.8%), while only 4.7% were returned to pharmacies. Of the HBM constructs, self-efficacy was the strongest predictor of response to cues for safe disposal behaviors (β = 0.184). Of all pharmacy retailers, only 17% were aware of disposal regulations and facilities. Major challenges included the lack of take-back systems (37.8%) and limited disposal facilities (24.5%). The study highlighted significant challenges in the management of unused and expired PPCPs among households and pharmacy retailers in Tokha municipality. CONCLUSIONS: Households and pharmacy retailers reported unsatisfactory waste disposal practices. Community-based awareness drives and pharmaceutical waste management modules boost self-efficacy by giving people the knowledge and confidence to safely handle and manage unused and expired PPCPs. In a case there are accessible municipal collection systems, pharmacy- or municipal-level take-back points, and clear regulatory mechanisms in the country, it becomes easier for individuals to accelerate that confidence into safety practices to reduce environmental deterioration and protect public health in Nepal.