This study describes the impact of exposure to secondhand smoke for subjects who spend time in a discotheque, by comparing within-subject baseline and postexposure urinary cotinine levels. A total of 100 nonsmoking volunteers from a central region of Mexico provided a urine sample before entering a discotheque and another sample an average of 6 hr after the end of exposure. Concentrations of cotinine and its metabolite, trans-3'-hydroxycotinine, were measured in the urine by liquid chromatography-mass spectrometry. In females the average preexposure level of urinary cotinine was 2.2 ng/ml, and the average postexposure level was significantly higher, at 15.7 ng/ml. In males the average preexposure level of cotinine was 3.7 ng/ml, compared with 49.1 ng/ml in the postexposure assessment. The highest postexposure values were found in men younger than 22 years old with a value of 469.5 ng/ml. Exposure to secondhand smoke is a serious health risk. Our findings are important given that many of our subjects were exposed to substantial amounts of secondhand smoke in discotheques, as evidenced by the high urinary cotinine and 3'-hydroxycotinine concentrations. These findings support the need to prohibit smoking in discotheques to protect nonsmokers' health.

Nicotine levels in the airport and public offices reflect the lack of compliance with mandatory non-smoking official regulations in Mexico. High nicotine concentrations in bars and restaurants provide evidence for the need to advance smoke-free legislative action in these public and work places.

S5 salud pública de méxico / vol.48, suplemento 1 de 2006 Los retos del Convenio Marco en México ARTÍCULO ORIGINALLos retos del convenio marco para el control del tabaco en México: un diagnóstico a partir de la Encuesta sobre Tabaquismo en JóvenesRaydel Valdés-Salgado, M en C, (1,2) James Thrasher, PhD, (3) Luisa María Sánchez-Zamorano, Dra en C,Eduardo Lazcano-Ponce, Dr en C, (1) Luz Myriam Reynales-Shigematsu, Dr en C,Fernando Meneses-González, M en C, (1) Mauricio Hernández-Ávila, Dr en C.Este trabajo es parte del proyecto final del primer autor para obtener el título de Master of Public Health (MPH) en la Escuela de Salud Pública de la Universidad Johns Hopkins.(1) Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México. El índice de susceptibilidad de iniciarse en el consumo de cigarrillos fue de 25%. A 60% de los fumadores que compraron cigarrillos no les negaron la venta por ser menores de edad. El 54% de los estudiantes declara que está expuesto al humo de tabaco en lugares públicos y 86% ha visto anuncios de cigarrillos en exteriores en el mes previo a la encuesta. Conclusión. Una intervención integral debe orientarse a impedir el acceso de los menores a los cigarri-

The World Health Organization Framework Convention on Tobacco Control (WHO-FCTC) promotes the implementation of best-practices tobacco control policies at a global scale. This article describes features of the sociocultural and political-economic context of Mexico that pose challenges and opportunities to the effective translation of WHO-FCTC policies there. It also considers how strategic communication efforts may advance these policies by framing their arguments in ways that resonate with prevalent values, understandings, and concerns. A focus on a smoke-free policy illustrates barriers to policy compliance, including how similar issues have been overcome among Latino populations in California. Overall, this article aims to lay the foundation for comparative research from policy uptake to impact so that the scientific evidence base on tobacco control policies includes examination of how context moderates this process.

This article is aimed to analyze the current situation of the tobacco epidemic in Mexico as well as progress in the struggle against tobacco. Mexico was the first country in the Americas to ratify the framework convention on tobacco control (FCTC). Currently, 36% of men over 18 are smokers and among women there is a prevalence of 13%. Besides this, 26% of the population is exposed to tobacco smoke from other smokers in the home. These figures vary slightly according to the source, and the definition used for smoker. Among adolescents, the initiation of tobacco consumption tends constantly towards an earlier age and no differences exist between men and women. In both cases, 19% had smoked in the month previous to the application of the Global Youth Tobacco Survey and 46% cohabit with other smokers. Among the principal challenges faced is the need to limit the access of minors to tobacco, as 37% of adolescent smokers buy cigarettes in the shops and 62% were not denied the purchase, because they were under age. Mortality attributable to tobacco in Mexico is estimated to be in the tens of thousands. Recently, a conservative estimate calculated that 25,383 deaths occur annually among those over 35 years of age, related to causes attributable to tobacco consumption.