Trajetória da política de controle do tabaco no Brasil de 1986 a 2016

Abstract

This study analyzes Brazil's tobacco control policy from 1986 to 2016, seeking to describe the policy's history and discuss its achievements, limits, and challenges. The study adopted a political economics approach and contributions from public policy analysis. Data were based on a search of the literature, documents, and secondary sources and semi-structured interviews with stakeholders involved in the policy. Factors related to the domestic and international contexts, the political process, and the policy's content influenced the institutional characteristics of tobacco control in the country. The study emphasizes the consolidation of Brazil's social rejection of smoking, government structuring of the policy, action by civil society, and Brazil's prestige in the international scenario. Inter-sector tobacco control measures like price and tax increases on cigarettes, the promotion of smoke-free environments, and the enforcement of health warnings contributed to the important reduction in prevalence of smoking. Implementation of the World Health Organization Framework Convention on Tobacco Control in Brazil, beginning in 2006, contributed to the expansion and consolidation of the national policy. However, tobacco-related economic interests limited the implementation of some strategic measures. The challenges feature the medium- and long-term sustainability of tobacco control and the solution to barriers involving crop diversification on current tobacco-growing areas, the fight against the illegal cigarette trade, and interference in the policy by the tobacco industry.

Prevalência e perfil de fumantes: comparações na população psiquiátrica e na população geral

“…Brazil's commitment to tobacco control is indisputable, as it was one of the first countries to sign the “Framework Convention on Tobacco Control” ( 10 ) . However, control actions are not only modifying the prevalence of smokers but also their distribution.…”

Prevalence of pre-gestational and gestational smoking and factors associated with smoking cessation during pregnancy, Brazil, 2011-2012

“…In Brazil, comprehensive tobacco control policies have been implemented over the past three decades and were intensified in 2005 with the ratification of World Health Organization Framework Convention on Tobacco Control (WHO FCTC) [15]. However, despite the considerable decline in prevalence overall and among women (25.3% in 1989 to 11.2 in 2013) [16–18], the number of maternal-fetal deaths in this period was devastating.…”

Institutions, Policy, and Non-Communicable Diseases (NCDs) in Latin America

“…Through this Advisory Group, medical doctors and influential senators proposed several policies prohibiting the usage of tobacco products in public places, private areas, public transportation, and in designated areas; this group built a consensus and presented a bill on these policy ideas in 1986, which was presented to the Congress and President José Sarney (Jaques, 2010). Moreover, the Advisor Group recommended and contributed to the formation of Brazil's firstnational program for tobacco control in 1986 (and provided subsequent technical assistance to it; Portes et al, 2018b), as well as creating Brazil's first national day to combat smoking campaign (Jaques, 2010). When it came to tobacco control, as early as 1996, NGOs also played a prominent role in helping emphasise the creation of national prevention programmes through the first Brazilian Congress for Tobacco Control (Iglesias et al, 2007).…”