Evidence map›Paper›PMID 40437559›Full record

ArticleBMC medicine2025

Compliance to tobacco and alcohol zoning regulations around schools in Bangladesh, India, Pakistan and Sri Lanka using environmental mapping data.

Lathika Athauda, Zoey Verdun, Petya Atanasova, Sajjad Ahmad, Ali Ahsan, Md Mokbul Hossain, Menka Loomba, Rajendra Pradeepa, Vindya Rajakaruna, Manuja Kaluarachchi and 10 more

Abstract read
In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Lathika AthaudaFaculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama, Sri Lanka. lathika@kln.ac.lk.
Zoey VerdunCentre for Health Economics & Policy Innovation, Imperial Business School, South Kensington Campus, Exhibition Rd, London, SW7 2 AZ, UK.
Petya AtanasovaCentre for Health Economics & Policy Innovation, Imperial Business School, South Kensington Campus, Exhibition Rd, London, SW7 2 AZ, UK.
Sajjad AhmadPunjab Institute of Cardiology, Lahore, Pakistan.
Ali AhsanCentre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
Md Mokbul HossainCentre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
Menka LoombaDevki Devi Foundation, New Delhi, India.
Rajendra PradeepaMadras Diabetes Research Foundation, Chennai, India.
Vindya RajakarunaFaculty of Medicine, University of Ruhuna, Matara, Sri Lanka.
Manuja KaluarachchiSchool of Public Health, Imperial College London, 90 Wood Ln, London , London, W12 0BZ, UK.
Anuradhani KasturiratneFaculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama, Sri Lanka.
Khadija Irfan KhawajaInstitute of Endocrinology and Metabolic Diseases, Services Institute of Medical Sciences, Lahore, Pakistan.
Malay K MridhaCentre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
Prasad KatulandaFaculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Vinitaa JhaDevki Devi Foundation, New Delhi, India.
Ranjit Mohan AnjanaMadras Diabetes Research Foundation, Chennai, India.
John C ChambersSchool of Public Health, Imperial College London, 90 Wood Ln, London , London, W12 0BZ, UK.
Gary FrostDepartment of Metabolism, Digestion and Reproduction, Faculty of Medicine, Faculty Building South Kensington Campus, Imperial College London, London, SW7 2 AZ, UK.
Franco SassiCentre for Health Economics & Policy Innovation, Imperial Business School, South Kensington Campus, Exhibition Rd, London, SW7 2 AZ, UK.
Marisa MiraldoCentre for Health Economics & Policy Innovation, Imperial Business School, South Kensington Campus, Exhibition Rd, London, SW7 2 AZ, UK.

Funding

Global Health Research Unit for Diabetes and Cardiovascular Disease South Asia funded by the NIHR with aid from the UK Government for Global Health Research NIHR (132960)National Institute of Health & Care Research, Global Health Research UK, Short Placement Award for Research Collaboration (SPARC Round 3)
6 · The paper itself

Abstract

backgroundThe built environment around schools that are regularly accessed by young people is determined by governments, national and regional policies in each country or region. Zoning regulations for tobacco and alcohol sales are expected to restrict availability and access by young people. This study aimed to examine (non) compliance with tobacco and alcohol zoning regulations around schools in Bangladesh, India, Pakistan and Sri Lanka.

methodsIn a representative sample of geographic locations in Bangladesh, India North (Delhi) and India South (Chennai), Pakistan and Sri Lanka, the built environment was mapped by systematically walking all streets within the site boundary to collect data on different types of tobacco and alcohol retailers and schools. Data was collected on KoboToolBox, and the maps indicating zoning compliance were created using ArcGIS. Descriptive analysis of outlet compliance to the zoning laws was conducted at the national and school levels, with heterogeneity analyses done by school type, income level and outlet type for tobacco and alcohol.

resultsThe zoning regulations for tobacco and alcohol differed among the settings ranging from 50 to 100 m for tobacco and absolute bans to 500 m for on-premise alcohol. Among the five different settings within the four countries, 441 areas were studied, including 3615 schools. Non-compliance with the zoning laws is evident in all jurisdictions for both tobacco and alcohol. Within restricted zones around schools (location non-compliant with zoning laws), 12-38% of outlets selling tobacco and 16% to 100% of outlets selling alcohol were identified. For supply non-compliance, 3-70% of shops within the school buffer zones were selling tobacco, while only 0.2-1% of shops were selling alcohol.

conclusionsNon-compliance with tobacco and alcohol zoning regulations has been observed around schools in Bangladesh, India (North and South), Pakistan and Sri Lanka. Within each country, there was a higher percentage of alcohol outlets that were location non-compliant than for tobacco, except for South India. In India and Sri Lanka, there was a higher percentage of supply non-compliance for tobacco than alcohol. This study calls for governments to strictly enforce existing zoning regulations that are expected to restrict access to tobacco and alcohol for young people.

Indexed as

Alcohol DrinkingAlcoholic BeveragesCommerceSchoolsTobacco ProductsBangladeshHumansIndiaPakistanSri LankaAdolescentsAlcoholBuilt environmentSchoolSouth AsiaTobacco

Identifiers

PMID40437559
PMCPMC12121219

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.