Tobacco Control Compliance With Point-of-Sale Tobacco Control Policies in School-Adjacent Neighborhoods in Mumbai, India Ritesh Mistry, PhD, MPH; Sharmila Pimple, MD; Gauravi Mishra, MD; Prakash C. Gupta, PhD; Mangesh Pednekar, PhD; Naomi Ranz-Schleifer, MPH; Surendra Shastri, MD Abstract Purpose. We assessed factors associated with tobacco vendor compliance with India’s Cigarettes and Other Tobacco Products Act (COTPA) provisions regulating tobacco sales and point-of-sale (POS) environments. Design. Study design was a cross-sectional random sample of tobacco vendors in Mumbai, India (2010). Setting. School-adjacent neighborhoods were the study setting. Subjects. Study subjects were tobacco vendors (n ¼ 436). Measures. Face-to-face interviews, and audits of POS environments were used to assess compliance. Analysis. Factors associated with compliance were identified using logistic regression. Results. About 4% of vendors were fully compliant. Although 80% reported compliance with the ban on tobacco sales to minors, only 10% displayed signage about the ban. About 84% were compliant with the two–tobacco advertisement limit; of those displaying advertisements, 67% were compliant with size limits, 68% with content restrictions, and 8% with health warning requirements. Knowledge about fines for noncompliance was associated with compliance with the ban on sales to minors (odds ratio [OR], 2.12; 95% confidence interval [CI], 1.26, 3.56) and signage requirement (OR, 4.42; 95% CI, 1.76, 11.13). Greater compliance with the two-advertisement limit was associated with higher store income from tobacco (OR, .26; 95% CI, .09, .73) and lower neighborhood socioeconomic status (p , .01); the latter was associated with advertisement size limits compliance (p , .05). Conclusions. Compliance with COTPA provisions was low. Interventions modifying vendor knowledge about provisions and fines may increase compliance, and they should target stores that are reliant on tobacco sales. (Am J Health Promot 0000;00[0]:1–8.) Key Words: Tobacco Control, Policy, Tobacco Access, Policy Compliance, Prevention Research. Manuscript format: research; Research purpose: evaluation; Study design: behavioral; Setting: community; Health focus: smoking control; Strategy: policy; Target population age: adults; Target population circumstances: urban and India PURPOSE In the coming decades, the already devastating global burden of diseases from tobacco use is expected to rise in low- and middle-income countries. 1 India will experience a disproportion- ately higher share of this burden because it is the second largest con- sumer of tobacco in the world. 2 The prevalence of adult and youth tobacco use in India is high, with 48% of adult males, 20% of adult females, 19% of adolescent males, and 8% of adoles- cent females reporting current tobacco use. 2–4 Because of the high prevalence of tobacco use, India experiences an estimated 1,000,000 deaths annually from tobacco-related diseases, making tobacco use a leading cause of prema- ture mortality. 5 With the Cigarettes and Other To- bacco Products Act (COTPA), 6 India has made significant commitments to reducing the future burden from tobacco-related diseases. At the time of this study, COTPA banned the sale of tobacco within 100 yards of education- al institutions and to persons younger Ritesh Mistry, PhD, MPH, is with the Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, and the Center of Cancer Prevention and Control Research, University of California, Los Angeles, California. Naomi Ranz- Schleifer, MPH, is with the Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan. Sharmila Pimple, MD; Gauravi Mishra, MD; and Surendra Shastri, MD, are with the Department of Preventive Oncology, Tata Memorial Hospital, Mumbai, India. Prakash C. Gupta, PhD, and Mangesh Pednekar, PhD, are with the Healis Sekhsaria Institute for Public Health, Navi Mumbai, India. Send reprint requests to Ritesh Mistry, PhD, Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH I, Room 3806, Ann Arbor, MI 48109-2029; riteshm@umich.edu. This manuscript was submitted September 25, 2014; revisions were requested December 3, 2014; the manuscript was accepted for publication January 21, 2015. Copyright Ó 0000 by American Journal of Health Promotion, Inc. 0890-1171/00/$5.00 þ 0 DOI: 10.4278/ajhp.140925-QUAN-469 American Journal of Health Promotion Month 0000, Vol. 0, No. 0 0